What is included in the long-term monitoring following treatment of Shiga toxin–producing E coli hemolytic-uremic syndrome (STEC-HUS)?

Updated: Nov 12, 2018
  • Author: Robert S Gillespie, MD, MPH; Chief Editor: Craig B Langman, MD  more...
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Answer

Patients recovering from Shiga toxin–producing E coli hemolytic-uremic syndrome (STEC-HUS) should have regular follow-up until their symptoms have resolved and their hemoglobin, platelet counts, and renal function have returned to normal.

Beyond that, no consensus is noted regarding frequency of follow-up or testing required. Preliminary data suggest many survivors may have persistent, subclinical renal injury, putting them at risk for future development of hypertension, proteinuria, and/or chronic renal disease. [47]

All patients should have their blood pressure checked at each medical encounter.

The authors suggest annual follow-up with a nephrologist, with consideration of annual urinalysis, urine microalbumin, serum creatinine, and fasting glucose levels on an annual basis.

Counsel patients on the importance of a healthy lifestyle, with regular exercise, healthy diet, and avoidance of tobacco and obesity. These measures are beneficial for all patients, but especially those at higher risk for future renal disease.

A cross-sectional study by Kreuzer et al that included 26 children with STEC-HUS reported endothelial dysfunction in 13 patients and also increased mean serum Ang2/Ang1 ratio compared to children in the healthy control group (each p <  0.05). [45]


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