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Published on: December 15, 2011

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

Masaki Shimizu1, Tadafumi Yokoyama, Natsuma Sakashita

  • 1Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan. shimizum@staff.kanazawa-u.ac.jp

Clinical Nephrology
|September 18, 2012
PubMed

Insights

Streptococcus pyogenes rarely causes hemolytic uremic syndrome (HUS). This study implicates T-antigen exposure in a child with GAS-associated HUS, suggesting a novel pathogenic mechanism.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Hematology

Background:

  • Hemolytic uremic syndrome (HUS) is a serious condition, often associated with infections.
  • Streptococcus pneumoniae is a known cause of HUS without diarrhea, involving the Thomsen-Friedenreich (T) antigen.
  • Group A Streptococcus (GAS) is a rare cause of HUS, with its pathogenesis not fully understood.

Observation:

  • A 3-year-old boy presented with HUS without diarrhea, negative stool cultures, and a positive direct Coombs test.
  • Pneumococcal urinary antigen testing was negative, ruling out typical pneumococcal HUS.
  • Renal biopsy and blood smear revealed T-antigen exposure on glomerular capillaries, tubular epithelium, and red blood cells.

Findings:

  • The case demonstrates a rare instance of GAS-associated HUS.
  • Positive T-antigen fluorescence in renal biopsy and blood smear suggests its involvement in the HUS pathophysiology.
  • This finding links T-antigen exposure to GAS infection in HUS.

Implications:

  • T-antigen exposure may play a role in the pathogenesis of some GAS-associated HUS cases.
  • This expands the understanding of HUS mechanisms beyond pneumococcal infections.
  • Further research is warranted to elucidate the precise role of T-antigen in GAS-associated HUS.

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