Hemolytic Uremic Syndrome (HUS) Caused by E. coli Shiga Toxins (Stx)

About two-thirds of the cases of hemolytic uremic syndrome (HUS) in the United States are a complication from Shiga-toxin (Stx) E. coli infections. E. coli O157 produces two Shiga toxins (Stx-1 and Stx-2), each causing different degrees and types of tissue damage in an infected person’s intestines.  Both Stx-1 and Stx-2 are capable of causing HUS; however, Stx-2 is most commonly associated with HUS. Other E. coli serotypes (referred to as non-O157 E. coli) also produce Stx-1 and/or Stx-2 and can cause HUS. The most common non-O157 serotypes are O26, O45, O103, O111, O121 and O145.

Stx-HUS is caused by food or water contaminated with E. coli. When E. coli bacteria are ingested (as few as 100 bacteria can cause illness), the E. coli bacterium reach the gut and adhere to the intestines. The E. colithen produce the Shiga toxins (Stx-1 and/or Stx-2), which are picked up by gastrointestinal cells and translocated into the blood circulation with the help of neutrophils, the most common type of white blood cell. Shiga toxins do not colonize in the blood, but are transported in the blood to other parts of the body, primarily the kidneys and, to a lesser extent, the central nervous system (CNS). Research suggests that the kidney is the most affected organ because the high volume of blood flow and filtration rate of blood in kidneys increase the chance of Stx interaction with cells, and that it contains the most cell types that are are receptive to Stx interaction, including endothelial cells, podocytes (visceral epithelial cells), mesangial cells, renal tubular cells and collecting duct cells.

Once the Shiga toxins get to the kidney, HUS quickly progresses as the toxins destroy cells, block protein synthesis, cause microvascular thrombosis (blood clots), hemolytic anemia, kidney damage and often kidney failure. Damage to the kidney causes additional problems.

People who develop Stx-HUS (usually children) become severely ill, and about 5 % of them die:

  • 70% of patients who develop HUS require red blood cell transfusions
  • 50% need dialysis
  • 25% have central nervous system problems, including stroke, seizure, and coma

All people who develop Stx-HUS are at risk for future kidney problems that may lead to a kidney transplant.

Pritzker Hageman food safety lawyers are some of the few attorneys in the United States who have handled Stx-HUS personal injury and wrongful death cases. Fred and his team are available for a free consultation regarding a lawsuit against a food manufacturer, restaurant or other company responsible for the illness. To contact our team,  call 888-377-8900 (toll free) or submit our free consultation form.

1. Norris M, Remuzzi G, Hemolytic Uremic Syndrome, Journal of the American Society of Nephrology (JASN), April 2005, Vol. 16, no. 4, 1035-1050.

2. Ray PE, Liu XH, Pathogenesis of Shiga toxin-induced hemolytic uremic syndrome, Pediatric Nephrology, October 2001, Vol. 10, 823-39.
3. Obrig T, Escherichia coli Shiga Toxin Mechanisms of Action in Renal Disease, Toxins 2010, 2, 2769-2794; doi:10.3390/toxins2122769

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Category: Food Poisoning
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