RGD Reference Report - Prothrombotic coagulation abnormalities preceding the hemolytic-uremic syndrome. - Rat Genome Database

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Prothrombotic coagulation abnormalities preceding the hemolytic-uremic syndrome.

Authors: Chandler, WL  Jelacic, S  Boster, DR  Ciol, MA  Williams, GD  Watkins, SL  Igarashi, T  Tarr, PI 
Citation: Chandler WL, etal., N Engl J Med. 2002 Jan 3;346(1):23-32.
RGD ID: 11541069
Pubmed: PMID:11777999   (View Abstract at PubMed)
DOI: DOI:10.1056/NEJMoa011033   (Journal Full-text)

BACKGROUND: The hemolytic-uremic syndrome is a thrombotic complication of Escherichia coli O157:H7 infection. It is not known whether the coagulation abnormalities precede, and potentially cause, this disorder. METHODS: In 53 children infected with E. coli O157:H7, we measured a panel of markers indicating activation of the clotting cascade and renal function within four days after the onset of illness. These markers were measured again in as many as possible of the 16 children in whom the hemolytic-uremic syndrome developed. RESULTS: The children in whom the hemolytic-uremic syndrome subsequently developed had significantly higher median plasma concentrations of prothrombin fragment 1+2, tissue plasminogen activator (t-PA) antigen, t-PA-plasminogen-activator inhibitor type 1 (PAI-1) complex, and D-dimer than children with uncomplicated infection. These abnormalities preceded the development of azotemia and thrombocytopenia. When the hemolytic-uremic syndrome developed, the urinary concentrations of beta2-microglobulin and N-acetyl-beta-glucosaminidase rose significantly (P=0.03 for both increases); the plasma concentrations of t-PA antigen, t-PA-PAI-1 complex, D-dimer, and plasmin-antiplasmin complex also increased significantly. The concentration of t-PA antigen correlated with that of the t-PA-PAI-1 complex in a linear regression model (squared correlation coefficient, 0.80; P<0.001). CONCLUSIONS: In the hemolytic-uremic syndrome, thrombin generation (probably due to accelerated thrombogenesis) and inhibition of fibrinolysis precede renal injury and may be the cause of such injury.

RGD Manual Disease Annotations    Click to see Annotation Detail View
TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
hemolytic-uremic syndrome  IEP 11541069associated with Escherichia coli Infections and protein:increased expression:plasma (human)RGD 
hemolytic-uremic syndrome  ISOPLAT (Homo sapiens)11541069; 11541069associated with Escherichia coli Infections and protein:increased expression:plasma (human)RGD 

Objects Annotated

Genes (Rattus norvegicus)
Plat  (plasminogen activator, tissue type)

Genes (Mus musculus)
Plat  (plasminogen activator, tissue)

Genes (Homo sapiens)
PLAT  (plasminogen activator, tissue type)


Additional Information