New insights into the pathogenesis of Streptococcus pneumoniae–associated hemolytic uremic syndrome

The purpose of this review is to describe Streptococcus pneumoniae –associated hemolytic uremic syndrome (P-HUS) with emphasis on new insights into the pathophysiology and management over the past 10 years. Even though awareness of this clinico-pathological entity has increased, it likely remains un...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2020-09, Vol.35 (9), p.1585-1591
Main Authors: Scobell, Rebecca R., Kaplan, Bernard S., Copelovitch, Lawrence
Format: Article
Language:English
Subjects:
Apheresis
Care and treatment
Children
Complement activation
Development and progression
Diagnosis
Diseases
Exo-a-sialidase
Hemolytic uremic syndrome
Medicine
Medicine & Public Health
Monoclonal antibodies
Nephrology
Pediatrics
Plasmapheresis
Review
Streptococcus infections
Streptococcus pneumoniae
Urology
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Summary:The purpose of this review is to describe Streptococcus pneumoniae –associated hemolytic uremic syndrome (P-HUS) with emphasis on new insights into the pathophysiology and management over the past 10 years. Even though awareness of this clinico-pathological entity has increased, it likely remains under-recognized. Recent observations indicate that although neuraminidase activity and exposure of the T-antigen are necessary for development of P-HUS, they are not sufficient; activation of the alternate pathway of complement may also contribute. It is unclear, however, whether or not eculizumab and/or plasmapheresis are of value.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-019-04342-3