Thelansis

  Non–Shiga toxin-associated HUS (non–Stx–HUS) comprises a heterogeneous group of patients in whom an infection by Stx-producing bacteria could be excluded as the cause of the disease. It can be sporadic or familial, with more than one family member affected by the disease and exposure to Stx-E. Coli excluded. Collectively, non–Stx–HUS forms have a poor outcome. Up to 50% of cases progress to ESRD or have irreversible brain damage, and 25% may die during the acute phase of the disease. After exposure to Stx-E. Coli, 38 to 61% of individuals develop hemorrhagic colitis, and 3 to 9% (in sporadic infections) to 20% progress to overt HUS. The average interval between E. coli exposure and illness is three days. The disease typically begins with abdominal cramps and nonbloody diarrhea; diarrhea may become hemorrhagic in 70% of cases, usually within 1 or 2 d. Vomiting occurs in 30 to 60% of cases, and fever occurs in 30%. Leukocyte count is generally elevated, and a barium enema may dem...