Abstract
Patients with classical HUS (n=22; median age 2;2 yrs) were prospectively studied at our institution since 1986. SLT-association was established by cytotoxicity assays of fecal filtrates, bacterial isolation or colony-blot-hybridization with SLT-specific DNA probes. Serial serum samples from 12 pts and appropriate controls were studied for SLT I and II neutralizing antibodies (NAB) and for hemagglutinating antibodies (HA) using erythocytes coated with purified LPS from E.coli 0157:H7 and other serovars. SLT association was demonstrated in 13/22 children (59%); E.coli isolates (n=6 pts) included serogroups 026, 055, 0111 and 0157; fecal SLT alone was present in 7 additional cases. 4 pts developed rising NAB-titers against SLT I or II; 9 pts (75%) presented with high LPS-0157-HA at the time of the diagnosis of HUS that rapidly declined during convalescence. Thus in Northern Germany an association of the classical HUS with in-vivo SLT production has been confirmed. Detection of LPS-0157-AB appears to be a new, valuable serological marker for this subgroup of HUS. Further studies are needed to elucidate a possible protective or pathogenic role of SLT- and LPS-specific AB.
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