Escherichia coli and the Hemolytic–Uremic Syndrome

The hemolytic–uremic syndrome is characterized by nonimmune hemolytic anemia, thrombocytopenia, and acute renal failure.¹ Extrarenal manifestations, particularly neurologic signs, may be present, indicating that the disease process is not limited to the kidney. As in the closely related disorder of thrombotic thrombocytopenic purpura, the pathologic hallmark of the disease is thrombotic microangiopathy. The hemolytic–uremic syndrome is the leading cause of acute renal failure in young children, but it occurs in adults as well, sometimes together with gastrointestinal infection and bloody diarrhea. Other forms of the syndrome in adults are related to pregnancy, the postpartum state, oral-contraceptive use, malignant hypertension, cancer . . .