Skip to main content

Advertisement

SpringerLink
Log in

Hemolytic uremic syndrome associated withEntamoeba histolytica intestinal infection

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Amebiasis secondary to Entamoeba histolytica (E. histolytica) continues to be a major source of morbidity and mortality worldwide, mainly in developing countries. An association between amebic dysentery and hemolytic uremic syndrome (HUS) has been mentioned, but a cause-and-effect relationship has never been confirmed. We report the case of an 11-year-old healthy white female who developed severe bloody diarrhea after drinking contaminated unboiled water, developing classic HUS and requiring acute intermittent hemodialysis. The etiological study confirmed numerous cysts and hematophagous trophozoites of E. histolytica on stool smear, but without evidence of other pathogens. This report contributes to the concept that classic post-diarrheal HUS, usually related to colitis secondary to enterohemorragic Shiga-toxin producing Escherichia coli (E.coli) strains, may be associated with other pathogens, including E. histolytica. Additional information regarding mechanisms of virulence of E. histolytica and host immunological reaction is needed to clarify the temporal association of these two disorders (HUS and amebiasis).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Petri W, Haque R, Lyerly D, Vines R (2000) Estimating the impact of amebiasis on health. Parasitol Today 16:320–321

    Article  PubMed  Google Scholar 

  2. Haque R, Huston C, Hughes M, Houpt E, Petri W (2003) Amebiasis. N Engl J Med 348:1565–1573

    Article  PubMed  Google Scholar 

  3. McKinney RE (1984) Hemolytic-uremic syndrome and Entamoeba histolytica infection. Pediatr Infect Dis 3:371

    Article  PubMed  Google Scholar 

  4. Biega T (2004) Hemolytic uremic syndrome. emedicine. http://www.emedicine.com/ped/topic960.htm

  5. Noris M, Remuzzi G (2005) Hemolytic uremic syndrome. J Am Soc Nephrol 16:1035–1050

    Article  CAS  PubMed  Google Scholar 

  6. Ashbolt NJ (2004) Microbial contamination of drinking water and disease outcomes in developing regions. Toxicology 198:229–238

    Article  CAS  PubMed  Google Scholar 

  7. Mirelman D, Katz U, Libros P, Perlman N, Nuchamowitz Y, Bracha R (2002) Molecular dissection of the virulence factors of the parasite Entamoeba histolytica. www.weizmann.ac.il/Biological_Chemistry/scientist/Mirelman/david_mirelman.html

  8. Lushbaugh WB, Kairalla AB, Hofbauer AF, Cantey JR, Pittman FE (1980) Further studies on a cytotoxin/enterotoxin from Entamoeba histolytica. Arch Invest Med (Mex) 11 [Suppl 1]:129–133

  9. Navarro-García F, Chávez-Dueñas L, Tsutsumi V, Posadas del Río F, López-Revilla R (1995) Entamoeba histolytica: increase of enterotoxicity and of 53- and 75-kDa cysteine proteinases in a clone of higher virulence. Exp Parasitol 80:361–372

    Article  Google Scholar 

  10. Wang W, Keller K, Chadee K (1992) Modulation of tumor necrosis factor production by macrophages in Entamoeba histolytica infection. Infect Immun 60:3169–3174

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Harrison LM, van Haaften WC, Tesh VL (2004) Regulation of proinflammatory cytokine expression by Shiga toxin 1 and/or lipopolysaccharides in the human monocytic cell line THP-1. Infect Immun 72:2618–2627

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Kim JM, Jung HC, Im K, Song IS, Kim CY (1998) Synergy between Entamoeba histolytica and Escherichia coli in the induction of cytokine gene expression in human colon epithelial cells. Parasitol Res 84:509–512

    CAS  PubMed  Google Scholar 

  13. Barker J, Humphrey T, Brown M (1999) Survival of Escherichia coli O157 in a soil protozoan: implications for disease. FEMS Microbiol Lett 173:291–295

    Article  CAS  PubMed  Google Scholar 

  14. Ludwig K, Sarkim V, Bitzan M, Karmali MA, Bobrowski C, Ruder H, Laufs R, Sobottka I, Petric M, Karch H, Muller-Wiefel DE (2002) Shiga toxin-producing Escherichia coli infection and antibodies against Stx2 and Stx1 in household contacts of children with enteropathic hemolytic-uremic syndrome. J Clin Microbiol 40:1773–1782

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Demircin G, Erdogan O, Bulbul M, Memis L (1998) Henoch Schonlein purpura and amebiasis. Acta Paediatr Jpn 40:489–491

    Article  CAS  PubMed  Google Scholar 

  16. Lecuit M, Martinez F, Deray G, Beaufils H, Gubler M, Nozais J, Bricaire F, Jacobs C (1997) Clinical and pathophysiological aspects of immune complex glomerulonephritis associated with Entamoeba histolytica abscess of the liver. Clin Infect Dis 25:335–336

    Article  CAS  PubMed  Google Scholar 

  17. Margolis J, Arganaras E, Margolis R (1971) Entamoeba histolytica associated with chronic glomerulonephritis: case report. J Am Geriatr Soc 19:646–648

    CAS  PubMed  Google Scholar 

  18. Germani Y, Minssart P, Vohito M, Yassibanda S, Glaziou P, Hocquet D, Berthelemy P, Morvan J (1998) Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. Am J Trop Med Hyg 59:1008–1014

    CAS  PubMed  Google Scholar 

  19. Kelleher P, Severn A, Tomson C, Lucas S, Parkin J, Pinching A, Miller R (1996) The haemolytic uraemic syndrome in patients with AIDS. Genitourin Med 72:172–175

    CAS  PubMed Central  PubMed  Google Scholar 

  20. Turner ME, Kher K, Rakusan T, D’Angelo L, Kapur S, Selby D, Ray PE (1997) A typical hemolytic uremic syndrome in human immunodeficiency virus-1-infected children. Pediatr Nephrol 11:161–163

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Catholic University School of Medicine, Lira 85, 5 Piso, Santiago, Chile

    Felipe Cavagnaro, Carla Guzmán & Paul Harris

Authors
  1. Felipe Cavagnaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carla Guzmán
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul Harris
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felipe Cavagnaro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cavagnaro, F., Guzmán, C. & Harris, P. Hemolytic uremic syndrome associated withEntamoeba histolytica intestinal infection. Pediatr Nephrol 21, 126–128 (2006). https://doi.org/10.1007/s00467-005-2069-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-005-2069-4

Keywords

Search

Navigation