HEMOLYTIC-UREMIC SYNDROME

The most important advances in the understanding of the pathogenesis of the hemolytic uremic syndrome in recent years has been the identification of the most likely etiological candidate, Escherichia coli O157:H7, and the continuing elucidation of the effects of its toxin, Shiga-like toxin, on endothelial cells. It has become clear that there are two main clinical types of hemolytic uremic syndrome, namely diarrhea associated and non-diarrheal associated. Important strides have been made in defining epidemiological aspects of the disease, including sources of contaminated food and water, identification of the sources of epidemics, and person-to-person spread. Although the acute mortality rate has continued to improve, treatment remains largely supportive, and no effective definitive treatment has been found for the renal or central nervous system injury.