Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-25T00:28:37.011Z Has data issue: false hasContentIssue false
  • English
  • Français

Haemolytic anaemia after childhood Escherichia coli O 157.H7 infection: are females at increased risk?

Published online by Cambridge University Press:  19 October 2009

P. C. Rowe ,
W. Walop ,
H. Lior  and
A. M. Mackenzie
P. C. Rowe
Affiliation:
Departments of Pediatrics, Epidemiology and Community Medicine and Laboratory Medicine, University of Ottawa School of Medicine, Ottawa, Canada, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
W. Walop
Affiliation:
Departments of Pediatrics, Epidemiology and Community Medicine and Laboratory Medicine, University of Ottawa School of Medicine, Ottawa, Canada, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
H. Lior
Affiliation:
Departments of Pediatrics, Epidemiology and Community Medicine and Laboratory Medicine, University of Ottawa School of Medicine, Ottawa, Canada, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
A. M. Mackenzie
Affiliation:
Departments of Pediatrics, Epidemiology and Community Medicine and Laboratory Medicine, University of Ottawa School of Medicine, Ottawa, Canada, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

We conducted a 4-year retrospective cohort study to better define the risk of haemolytic anaemia and haemolytic uraemic syndrome (HUS) in children following sporadic gastrointestinal infection with the O 157.H7 serotype of Escherichia coli. Of the 72 children infected with this organism, 9 (12·5%) developed haemolytic anaemia, 6 of whom had HUS. No child in a cohort of 72 age-matched controls with Campylobacter jejuni gastroenteritis developed haemolytic anaemia (P = 0·003). Females had a significantly greater risk of developing haemolytic anaemia after E. coli O 157.H7 infection than did males (8/29 females v. 1/43 males; P = 0·003). In a logistic regression model, female gender emerged as the only statistically significant risk factor for haemolytic anaemia (odds ratio 3·85; 95% confidence interval 1·24–12). These results are consistent with recent reports of a moderate increase in the risk of HUS for females.

Type
Research Article
Information
Epidemiology & Infection , Volume 106 , Issue 3 , June 1991 , pp. 523 - 530
Copyright
Copyright © Cambridge University Press 1991

References

REFERENCES

1.Karmali, MA, Petric, M, Steele, BT, Lim, C. Sporadic cases of haemolytic-uremic syndrome associated with faecal cytotoxin-producing Escherichia coli in stools. Lancet 1983; i: 619–20.CrossRefGoogle Scholar
2.Kaplan, BS, Proesmans, W. The hemolytic uremic syndrome of childhood and its variants. Semin Hematol 1987; 24: 148–60.Google ScholarPubMed
3.Dolislager, D, Tune, B. The hemolytic-uremic syndrome: spectrum of severity and significance of prodrome. Am J Dis Child 1978; 132: 55–8.CrossRefGoogle ScholarPubMed
4.Rogers, MF, Rutherford, GW, Alexander, SR, DiLiberti, JH, Foster, L, Schonberger, LB, Hurwitz, ES. A population-based study of hemolytic-uremic syndrome in Oregon, 1979–82. Am J Epidem 1986; 123: 137–42.CrossRefGoogle Scholar
5.Neill, MA, Christie, DL, Tarr, PI, Clausen, CR. Subclinical hemolytic uremie syndrome in cases of hemorrhagic colitis with E. coli 0 157. H7. International symposium and workshop on verocytotoxin-producing Escherichia coli infections. Toronto, 07 1987.Google Scholar
6.Karmali, MA, Petric, M, Lim, C, Fleming, PC, Arbus, GS, Lior, H. The association between idiopathic hemolytic uremic syndrome and infection by verotoxin-producing Escherichia coli. J Inf Dis 1985; 151: 775–82.CrossRefGoogle ScholarPubMed
7.Grandsen, WR, Damm, MAS, Anderson, JD, Carter, JE, Lior, H. Further evidence associating hemolytic uremic syndrome with infection by verotoxin-producing Escherichia coli 0 157. H7. J Inf Dis 1986; 154: 522–4.Google Scholar
8.Hockin, J, Lior, H. Hemorrhagic colitis and hemolytic uremic syndrome caused by Escherichia coli 0 157. H7 in Canada. Can Dis Weekly Rep 1987; 13: 203–6.Google Scholar
9.MA, Neill, Tarr, PI, Clausen, CR, Christie, DL, Hickman, ROEscherichia coli 0 157. H7 as the predominant pathogen associated with the hemolytic uremic syndrome: a prospective study in the Pacific Northwest. Pediatrics 1987; 80: 37–40.Google Scholar
10.Spika, JS, Parsons, JE, Nordenberg, D, Wells, JG, Gunn, RA, Blake, PA. Hemolytic uremic syndrome and diarrhea associated with Escherichia coli O 157.H7 in a day care center. J Pediatr 1986; 109: 287–91.CrossRefGoogle Scholar
11.Duncan, L, Mai, V, Carter, A, Carlson, JAK, Borczyk, A, Karmali, MA. Outbreak of gastrointestinal disease in Sarnia, Ontario. Ontario Dis Surveillance Rep 1986; 7: 604–11.Google Scholar
12.Pai, CH, Ahmed, N, Lior, H, Johnson, WM, Sims, HV, Woods, DE. Epidemiology of sporadic diarrhea due to verocytotoxin-producing Escherichia coli: a two year prospective study. J Inf Dis 1988; 157: 1054–7.CrossRefGoogle ScholarPubMed
13.Lubin, BH. Reference values in infancy and childhood. In: Nathan, DG, Oski, FA, eds. Hematology of infancy and childhood, 3rd ed.Philadelphia: WB Saunders, 1987.Google Scholar
14.Konowalchuk, J, Speirs, JI, Stravric, S. Vero response to a cytotoxin of Escherichia coli. Infect Immun 1977; 18: 775–9.CrossRefGoogle ScholarPubMed
15.Pollard, DR, Johnson, WM, Lior, H, Tyler, SD, Rozee, KR. Rapid and specific detection of verotoxin genes in Escherichia coli by the polymerase chain reaction. J din Microbiol 1990; 28: 540–5.Google ScholarPubMed
16.Daniel, WW. Biostatistics: a foundation for analysis in the health sciences, 3rd ed.New York: John Wiley & Sons, 1983.Google Scholar
17.Schlesselman, JJ. Case-control studies: design, conduct, analysis. New York: Oxford University Press, 1982.Google Scholar
18.McLaine, PN, Rowe, PC, Wells, GA, Orrbine, E, and members of the pediatrics section of the Canadian Society of Nephrology. A collaborative study of childhood HUS in Canada, 1986–1988. Pediatr Res 1990; 27: 333A.Google Scholar
19.Radetsky, M.Laboratory evaluation of acute diarrhea. Ped Inf Dis 1986; 5: 230–8.CrossRefGoogle ScholarPubMed
20.Cimolai, N, Carter, JE, Morrison, BJ, Anderson, JD. Risk factors for the progression of Escherichia coli 0 157. H7 enteritis to hemolytic-uremic syndrome. J Pediatr 1990; 116: 589–92.CrossRefGoogle Scholar
21.Gianantonio, C, Vitacco, M, Mendilaharzu, F, Rutty, A, Mendilaharzu, J.The hemolyticuremic syndrome. J Pediatr 1964; 64: 478–91.CrossRefGoogle Scholar
22.Kinney, JS, Gross, TP, Porter, CC, Rogers, MF, Schonberger, LB, Hurwitz, ES. Hemolytic-uremic syndrome: a population-based study in Washington, DC and Baltimore, Maryland. Am J Public Health 1988; 78: 64–5.CrossRefGoogle ScholarPubMed
23.British Pediatric Association – Communicable Disease Surveillance Centre surveillance of haemolytic uraemic syndrome 1983–1984. Br Med J 1986; 292: 115–7.CrossRefGoogle Scholar
24.Karmali, MA. Infection by verocytotoxin-producing Escherichia coli, Clin Microbiol Rev 1989; 2: 15–38.CrossRefGoogle ScholarPubMed
25.Cleary, TG, Lopez, EL. The Shiga-like toxin-producing Escherichia coli and hemolytic uremic syndrome. J Ped Inf Dis 1989; 8: 720–4.CrossRefGoogle Scholar
26.Lingwood, CA, Law, H, Richardson, S, Petric, M, Brunton, JL, DeGrandis, S, Karmali, M.Glycolipid binding of purified and recombinant Escherichia coli produced verotoxin in vitro. J Biol Chem 1987; 262: 8834–9.CrossRefGoogle ScholarPubMed
27.Boyd, B, Lingwood, C.Verotoxin receptor glycolipid in human renal tissue. Nephron 1989; 51: 207–10.CrossRefGoogle ScholarPubMed
28.Taylor, CM, Milford, DV, Rose, PE, Roy, TCF, Rowe, B. The expression of blood group PI in post-enteropathic haemolytic uraemic syndrome. Pediatr Nephrol 1990; 4: 59–61.CrossRefGoogle Scholar
29.Washburn, TC, Medearis, DN, Childs, B. Sex differences in susceptibility to infections. Pediatrics 1965; 35: 57–64.CrossRefGoogle ScholarPubMed
30.Childs, B, Moxon, ER, Winkelstein, JA. Genetics and infectious diseases. Unpublished observations.Google Scholar
31.Purtilo, DT, Sullivan, JL. Immunological bases for superior survival of females. Am J Dis Child 1979; 133: 1251–3.Google ScholarPubMed
32.Michaels, RH, Rogers, KD. A sex difference in immunologic responsiveness. Pediatrics 1971; 47: 120–3.CrossRefGoogle ScholarPubMed
33.Law, BJ, Marks, MI. Age related prevalence of human serum IgG and IgM antibody to the core glycolipid of Escherichia coli strain J5, as measured by ELISA. J Inf Dis 1985; 151: 988–94.CrossRefGoogle Scholar
34.Grundbacher, FJ. Human X chromosome carries quantitative gene for immunoglobulin M. Science 1972; 176: 311–2.CrossRefGoogle ScholarPubMed
35.Nurmi, T.The association of serum IgM and IgG levels with the number of X chromosomes in patients with abnormal numbers. J Immunogenet 1982; 9: 155–63.CrossRefGoogle Scholar
36.Leung, DYM, Moake, JL, Havens, PL, Kim, M, Pober, JS. Lytic anti-endothelial cell antibodies in haemolytic uraemic syndrome. Lancet 1988; ii: 183–6.CrossRefGoogle Scholar