Some of the information in this post is from an article entitled, “Renal and neurological involvement in typical Shiga toxin-associated HUS” (see the citation below).
Hemolytic uremic syndrome (HUS) is a complication of an E. coli infection, usually E. coli O157:H7, a Shiga toxin producing bacteria that colonizes in human intestines after ingestion of contaminated food or water. Most cases of HUS in the United States are caused by E. coli O157:H7. The CDC recommends that E. coli O157 not be treated with antibiotics because some studies have found that they greatly increase the risk of developing HUS.
E. coli-HUS is a devastating illness. Attorney Fred Pritzker has represented many E. coli-HUS victims and their families in personal injury and wrongful death cases against food manufacturers, retailers, restaurants and others. Every case involved renal failure and dialysis (haemodialysis or peritoneal); most cases also involved some damage to the brain. This is because the kidney and the brain are the two primary target organs of HUS.1
HUS and Renal (Kidney) Damage
All E. coli-HUS victims have some renal damage, and around 40% will have renal failure and need dialysis. The quote below is from the article referenced at the bottom of this post. “Stx” refers to Shiga toxin, the toxins produced by E. coli bacteria. Basically, the toxins bind to some kidney cells (there are different kinds of cells in this complex organ), killing them and thus preventing them from doing their job. The end result is a sick kidney that can’t work to excrete waste from the body. E. coli-HUS is referred to as STEC-HUS because it is caused by Shiga toxin producing Escherichia coli.
Stx binds to both the glomerulus and proximal tubules in patients with STEC-HUS, although glomerular binding is lower in elderly patients than in pediatric patients with the disease.Within the glomerulus, Stx binds to podocytes, mesangial cells, and glomerular endothelial cells in human tissue.In the kidney of three children who died during an episode of STEC-HUS, Stx1 and Stx2 were detected in these cellular locations by immunohistochemical staining. These results are based on a limited sample and caution is warranted before generalizing findings. The toxin has also been localized to the distal tubule in clinical specimens, which supports preclinical data that Stx has direct effects on this nephron segment.
If you made it through the above quote, you get an idea of the complexity of the pathology of E. coli-HUS. The renal damage can be permanent and greatly increases the risk of future kidney disease.
HUS and the Brain
Seizures are often the first sign that E. coli-HUS has injured the brain, and the mortality rate for E. coli victims who experience seizures and/or coma is higher. Seizures usually do not last long, but some children may have a prolonged seizure or a series of seizures that can lead to death.
Below is another quote from the Trachtman article:
Neurological involvement is the most life-threatening acute complication of STEC-HUS and can cause sudden death. The complication occurs in 20–25% of patients with STEC-HUS. The disease is associated with a wide range of neurological disturbances, including lethargy, apnoea, coma, seizures, [stroke], cortical blindness, and haemiparesis.Some evidence indicates that the frequency and severity of neurological complications might be related to the intensity of the antecedent enteritis, evidenced by the degree of bloody diarrhoea and gastrointestinal symptoms. The neurological manifestations represent a combined effect of Stx-induced vascular injury, endothelial dysfunction, hypertension, and electrolyte disorders. This concurrence of multiple abnormalities simultaneously in the same patient may account for the severity of the neurological disease in patients with STEC-HUS.
Again, there are long-term consequences. According to Trachtman, “Long-term neurological outcomes include haemiparesis, blindness, seizures, and learning disabilities.”
Attorney Fred Pritzker and his Bad Bug Law Team represent E. coli victims and their families throughout the United States in personal injury and wrongful death lawsuits against food manufacturers, retailers, restaurants and others.
Reference: Trachtman, Howard, Catherine Austin, Maria Lewinski, and Rolf AK Stahl. “Renal and neurological involvement in typical Shiga toxin-associated HUS.” Nature Reviews Nephrology (2012). The authors of this article were not contacted, nor are they responsible for the content of this post. We would like to thank them for their valuable work in this area and welcome them to contact us with any concerns about our use of information we found in their article.