Usefulness of serum fibrinogen degradation product-E in sporadic cases of classical hemolytic uremic syndrome

Background: Hemolytic uremic syndrome (HUS) associated with Shiga toxin (Stx)-producing Escherichia coli O157:H7 infection is one of the diseases causing acute renal failure in young children. Although HUS is still a serious disease in children, no reliable predictive markers for HUS nor markers of disease severity are available so far. Recently, we experienced a sporadic case of typical HUS caused by Stx-producing E. coli O157:H7 and detected, at the prodromal stage, a high level of serum fibrin/fibrinogen degradation product-E (FDP-E) fraction. Methods: To assess the usefulness of FDP-E for the treatment of HUS in clinical practice, we retrospectively examined serum levels of FDP-E in 22 patients with bloody diarrhea with or without HUS. Results: There were significantly increased levels of serum FDP-E in patients with HUS, but not in those without HUS. Furthermore, serum levels of FDP-E may correlate with disease severity in patients with HUS. Conclusions: These results suggest that serum levels of FDP-E may be a useful marker of HUS in clinical practice.