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. 2018 Jul;84(1):118-124.
doi: 10.1038/s41390-018-0009-9. Epub 2018 May 23.

Gastrointestinal pathogens in anti-FH antibody positive and negative Hemolytic Uremic Syndrome

Shambhuprasad K Togarsimalemath  1   2 , Ali Si-Mohammed  3 , Mamta Puraswani  4 , Aarti Gupta  4 , Astrid Vabret  5 , Sandrine Liguori  6 , Patricia Mariani-Kurkdjian  6 , Arvind Bagga  4 , Marie-Agnes Dragon-Durey  7   8   9
Affiliations

Gastrointestinal pathogens in anti-FH antibody positive and negative Hemolytic Uremic Syndrome

Shambhuprasad K Togarsimalemath et al. Pediatr Res. 2018 Jul.

Abstract

Background: Prodromal symptoms are frequently reported in the atypical form of Hemolytic uremic syndrome (aHUS) suggesting implication of infectious triggers. Some pathogens may also play a role in the mechanisms of production of autoantibody directed against Factor H (FH), a complement regulator, leading to aHUS.

Methods: The presence of 15 gastrointestinal (GI) pathogens was investigated by using xTAG-based multiplex PCR techniques on stools collected at the acute phase in a cohort of Indian HUS children classified according to the presence or absence of anti-FH autoantibodies.

Results: Prevalence of pathogens in patients with anti-FH antibody (62.5%) was twice that in those without (31.5%). Different pathogens were detected, the most frequent being Clostridium difficile, Giardia intestinalis, Salmonella, Shigella, Rotavirus, Norovirus and Entamoeba histolytica. No stool was positive for Shigatoxin.

Conclusion: This study reveals a higher prevalence of GI pathogens in anti-FH positive than in negative patients. No single pathogen was implicated exclusively in one form of HUS. These pathogens may play a role in the disease initiation by inducing complement activation or an autoimmune response.

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References

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