ArticlePediatric nephrology (Berlin, Germany)2016
Fecal diagnostics in combination with serology: best test to establish STEC-HUS.
Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 42 citations in OpenAlex.
- Serology as an early diagnostic tool in pediatric patients with Shiga toxin-producingJournal of clinical microbiology · 2026Trial
- Improving hemolytic uremic syndrome diagnosis in children: the role of serology for Shiga toxin-producing Escherichia coli detection.Pediatric nephrology (Berlin, Germany) · 2026Article
- Incidence and severity of extrarenal manifestations and outcomes in pediatric hemolytic uremic syndrome: a retrospective cohort study.Pediatric nephrology (Berlin, Germany) · 2026Article
- INM004: Polyclonal Neutralizing Antibodies Against Shiga Toxin as a Treatment for Hemolytic Uremic Syndrome.Toxins · 2025Review
- Development of a set of bacterial engineered glycoconjugates as novel serogroup-specific antigens for the serodiagnosis of Escherichia coli O26, O111, O103 and O45 infections associated to hemolytic uremic syndrome.Microbial cell factories · 2025Article
- A novel multiplex and glycoprotein-based immunochromatographic serologic IgM test for the rapid diagnosis ofJournal of clinical microbiology · 2024Article
- Practical approach to thrombocytopenia in patients with sepsis: a narrative review.Thrombosis journal · 2024Review
- How to Improve Surveillance Program for Shiga Toxin-ProducingPathogens (Basel, Switzerland) · 2024Article
- HELLP Syndrome and Differential Diagnosis with Other Thrombotic Microangiopathies in Pregnancy.Diagnostics (Basel, Switzerland) · 2024Review
- Constipation and hemolytic uremic syndrome.Pediatric nephrology (Berlin, Germany) · 2024Article
- Enzymatic Cleavage of Stx2a in the Gut and Identification of Pancreatic Elastase and Trypsin as Possible Main Cleavers.Microorganisms · 2023Article
- Diagnosis and Treatment for Shiga Toxin-ProducingToxins · 2022Review
- Neutrophil Extracellular Traps Induced by Shiga Toxin and Lipopolysaccharide-Treated Platelets Exacerbate Endothelial Cell Damage.Frontiers in cellular and infection microbiology · 2022Article
- Complement in Secondary Thrombotic Microangiopathy.Kidney international reports · 2021Review
- Review
- Heme as Possible Contributing Factor in the Evolvement of Shiga-ToxinFrontiers in immunology · 2020Article
- Hemolytic uremic syndrome in a developing country: Consensus guidelines.Pediatric nephrology (Berlin, Germany) · 2019Article
- Diarrhea-associated Hemolytic Uremic Syndrome in Adults: Two Case Reports and Review of the Literature.Cureus · 2019Article
- Glyco-iELISA: a highly sensitive and unambiguous serological method to diagnose STEC-HUS caused by serotype O157.Pediatric nephrology (Berlin, Germany) · 2019Article
- Unusual severe case of hemolytic uremic syndrome due to Shiga toxin 2d-producing E. coli O80:H2.Pediatric nephrology (Berlin, Germany) · 2017Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the majority of pediatric patients, the hemolytic-uremic syndrome (HUS) is caused by an infection with Shiga toxin-producing Escherichia coli (STEC), mostly serotype O157. It is important to discriminate between HUS caused by STEC and complement-mediated HUS (atypical HUS) due to differences in treatment and outcome. As STEC and its toxins can only be detected in the patient's stool for a short period of time after disease onset, the infectious agent may go undetected using only fecal diagnostic tests. Serum antibodies to lipopolysaccharide (LPS) of STEC persist for several weeks and may therefore be of added value in the diagnosis of STEC.
methodsAll patients with clinical STEC-HUS who were treated at Radboud University Medical Center between 1990 and 2014 were included in this retrospective single-center study. Clinical and diagnostic microbiological data were collected. Immunoglobulin M (IgM) antibodies against LPS of STEC serotype O157 were detected by a serological assay (ELISA).
resultsData from 65 patients weres available for analysis. Fecal diagnostic testing found evidence of an STEC infection in 34/63 patients (54 %). Serological evidence of STEC O157 was obtained in an additional 16 patients. This is an added value of 23 % (p < 0.0001) when the serological antibody assay is used in addition to standard fecal diagnostic tests to confirm the diagnosis STEC-HUS. This added value becomes especially apparent when the tests are performed more than 7 days after the initial manifestation of the gastrointestinal symptoms.
conclusionsThe serological anti-O157 LPS assay clearly makes a positive contribution when used in combination with standard fecal diagnostic tests to diagnose STEC-HUS and should be incorporated in clinical practice.
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