Immunoadsorption Therapy Effective in E. coli-Induced HUS

Immunoadsorption effective, safe for neurological complications of hemolytic uremic syndrome

TUESDAY, Sept. 6 (HealthDay News) -- Immunoadsorption of immunoglobulin G (IgG) antibodies can safely be used to treat neurological complications in patients with Escherichia coli (E. coli) O104:H4-induced hemolytic uremic syndrome (HUS), according to a study published online Sept. 5 in The Lancet.

Andreas Greinacher, M.D., from the Institut für Immunologie und Transfusionmedizin in Greifswald, Germany, and colleagues investigated the use of immunoadsorption for the treatment of post-enteritis HUS and thrombotic microangiopathy in 12 patients with severe neurological symptoms and recently confirmed E. coli O104:H4 infection. IgG immunoadsorption processing of 12 L plasma volumes was performed on two consecutive days followed by 0.5 g/kg intravenous IgG replacement. Composite neurological symptom score was calculated daily and changes before and after immunoadsorption were evaluated.

The investigators found that renal replacement therapy was required by 10 of the 12 patients in a median of eight days. Neurological complications were observed at a median of eight days, and necessitated mechanical ventilation in nine patients. The composite neurological symptom scores improved significantly, from 3.0 in the three days before immunoadsorption to 1.0 three days afterward. Improvement was observed (disappearance of aphasia) in non-intubated patients during immunoadsorption. Among the nine patients who were intubated, five were weaned within 48 hours, two within four days, and two continued ventilation for respiratory problems. All 12 patients survived and 10 experienced complete neurological and renal function recovery.

"Our study is the first to show effectiveness of immunoadsorption for treatment of severe neurological complications related to E. coli 0104:H4 hemolytic uremic syndrome," the authors write.

Two authors disclosed financial ties to Fresenius Medical Care.

Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Copyright © 2011 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Debunking Three Rape Myths
Journal of Forensic Nursing, October/December 2014
Expires: 12/31/2016 CE:2.5 $24.95


Drug updates and approvals: 2014 in review
The Nurse Practitioner, 13December 2014
Expires: 12/31/2016 CE:3 $27.95


Can Food Processing Enhance Cancer Protection?
Nutrition Today, September/October 2014
Expires: 10/31/2016 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events