ArticleEuropean journal of pediatrics2018
Complement activation is associated with more severe course of diarrhea-associated hemolytic uremic syndrome, a preliminary study.
Article in European journal of pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Acute kidney injury due to diarrhoeal diseases in children: a systematic review.BMJ paediatrics open · 2026Pooled it
- Eculizumab in Shiga toxin-producing Escherichia coli hemolytic uremic syndrome: a systematic review.Pediatric nephrology (Berlin, Germany) · 2024Pooled it
- Molecular determinants of STEC-HUS: from complement activation to microvascular thrombosis.Frontiers in immunology · 2026Article
- Shiga Toxin-ProducingKidney international reports · 2025Article
- IgG-immunoadsorptions and eculizumab combination in STEC-hemolytic and uremic syndrome pediatric patients with neurological involvement.Pediatric nephrology (Berlin, Germany) · 2025Article
- HUS with mutations in CFH and STEC infection treated with eculizumab in a 4-year-old girl.Pediatric nephrology (Berlin, Germany) · 2023Article
- Trastuzumab/pertuzumab combination therapy stimulates antitumor responses through complement-dependent cytotoxicity and phagocytosis.JCI insight · 2022Article
- Hemolytic uremic syndrome due to Shiga toxin–producing Escherichia coli and hypocomplementemia with favorable response to eculizumab: a case reportRevista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2021Article
- Frequency of neurological involvement in patients with/without diarrhea hemolytic uremic syndrome: A Systematic review and meta-analysis.Medical journal of the Islamic Republic of Iran · 2021Article
- Therapeutic Strategies to Protect the Central Nervous System against Shiga Toxin from EnterohemorrhagicCurrent neuropharmacology · 2021Article
- Molecular basis and outcomes of atypical haemolytic uraemic syndrome in Czech children.European journal of pediatrics · 2020Article
- Research methodology used in the 50 most cited articles in the field of pediatrics: types of studies that become citation classics.BMC medical research methodology · 2020Article
- C3 levels and acute outcomes in Shiga toxin-related hemolytic uremic syndrome.Pediatric nephrology (Berlin, Germany) · 2020Article
- Low C3 Serum Levels Predict Severe Forms of STEC-HUS With Neurologic Involvement.Frontiers in medicine · 2020Article
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Authors and funding
7 authors at 3 institutions in 1 country.
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Abstract
Diarrhea-associated hemolytic uremic syndrome is characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury secondary to enteric infection, typically Shiga toxin-producing Escherichia coli. Shiga toxin 2 is able to activate alternative complement pathways; therefore, the aim of the study was to analyze C3 as a predictor of clinical courses in patients with diarrhea-associated hemolytic uremic syndrome. We hypothesized that the patients with increased complement activation at admission suffered from a more severe course. We retrospectively analyzed data of 33 pediatric patients between 1999 and 2015 in the Czech Republic. We tested the association of a C3 concentration with biochemical parameters and the clinical data reflecting the severity of the disease. We found significant correlation between the initial C3 and the duration of renal replacement therapy (r = - 0.62, p = 0.0001) and the initial glomerular filtration rate (r = 0.36, p = 0.026). Patients with C3 < 0.825 g/L needed renal replacement therapy and also had significantly more renal complications (p = 0.015).Conclusion: Based on our study, decreased C3 concentrations can be used as one of the risk factors that can help predict the need for acute dialysis and a more severe course of disease in children with diarrhea-associated hemolytic uremic syndrome. What is Known: • Shiga toxin modulates the function of complement regulatory proteins and thus contributes to complement activation in patients with diarrhea-associated hemolytic uremic syndrome. • Risk factors that can predict the need for acute renal replacement therapy and poor outcome in patients with diarrhea-associated hemolytic uremic syndrome are mainly the combination of oligoanuria, dehydration, leukocytosis, high hematocrit > 23%, and neurological involvement. What is New: • A lowered concentration of C3 at the time of initial presentation of diarrhea-associated hemolytic uremic syndrome was associated with more severe renal failure and the need for renal replacement therapy along with the development of more extra renal complications. • Decreased C3 at admission can predict complicated course of diarrhea-associated hemolytic uremic syndrome.
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