DOI 10.5414/CN107205

Clinical Nephrology, Volume 78 (2012) - October (328 - 331)

Thomsen-Friedenreich antigen exposure as a cause of Streptococcus pyogenes-associated hemolytic-uremic syndrome

Masaki Shimizu1, Tadafumi Yokoyama1, Natsuma Sakashita1, Akira Sato1, Kazuyuki Ueno1, Chisato Akita2, Kazuhide Ohta3, Etsuko Kitano4, Michiyo Hatanaka4, Hajime Kitamura5, Yutaka Saikawa2, Akihiro Yachie1
1 Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, Health Sciences, Kanazawa University, Kanazawa, 2 Department of Pediatrics, School of Medicine, Kanazawa Medical University, Uchinada, 3 Department of Pediatrics, Kanazawa Medical Center, Kanazawa, 4 Department of Medical Technology, Kobe Tokiwa University, Kobe, 5 Department of Nutritional Sciences for Wellbeing, Kansai University of Welfare Sciences, Kashiwara, Osaka, Japan

Abstract

Infection with Streptococcus pyogenes, a Group A beta-hemolytic streptococcus (GAS), is a rare cause of hemolyticuremic syndrome (HUS). Invasive infections with Streptococcus pneumoniae that produce neuraminidase are a well-recognized cause of HUS without diarrhea. The Thomsen- Friedenreich antigen (T antigen) plays a role in the pathophysiology of pneumococcal HUS. We describe the case of a 3-year-old boy with GAS-associated HUS and show how T-antigen exposure was implicated in this case. He had no diarrhea and cultures for blood, urine, and stool were negative. The urinary pneumococcal antigen was negative; his direct Coombs test was positive. Glomerular capillary loops, tubular epithelium on his renal biopsy specimen, and red blood cells in his blood smear showed positive fluorescence with anti-T lectin. Although the pathogenesis of GAS-associated HUS is not well understood, T-antigen exposure may be implicated in some cases with GAS-associated HUS.

Author Details

Authors

  • Masaki Shimizu1
  • Tadafumi Yokoyama1
  • Natsuma Sakashita1
  • Akira Sato1
  • Kazuyuki Ueno1
  • Chisato Akita2
  • Kazuhide Ohta3
  • Etsuko Kitano4
  • Michiyo Hatanaka4
  • Hajime Kitamura5
  • Yutaka Saikawa2
  • Akihiro Yachie1

Departments

  • 1 Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, Health Sciences, Kanazawa University, Kanazawa,
  • 2 Department of Pediatrics, School of Medicine, Kanazawa Medical University, Uchinada,
  • 3 Department of Pediatrics, Kanazawa Medical Center, Kanazawa,
  • 4 Department of Medical Technology, Kobe Tokiwa University, Kobe,
  • 5 Department of Nutritional Sciences for Wellbeing, Kansai University of Welfare Sciences, Kashiwara, Osaka, Japan

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