Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (668 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A syndrome that is associated with microvascular diseases of the kidney, such as renal cortical necrosis. It is characterized by hemolytic anemia (anemia, hemolytic); thrombocytopenia; and acute renal failure.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Hemolytic Uremic Syndrome; Syndrome, Hemolytic-Uremic; Gasser Syndrome; Gasser's Syndrome; Gassers Syndrome.
Where it fits in the MeSH classification
- Broader topics
- Uremia; Anemia, Hemolytic; Thrombotic Microangiopathies
- Narrower topics
- Atypical Hemolytic Uremic Syndrome
Related concepts
- Kidney
- Renal Cortical Necrosis
- Anemia
- Hemolytic
- Thrombocytopenia
- Acute Kidney Injury
Research landscape
PubMed indexes 6,768 records tagged with the MeSH heading “Hemolytic-Uremic Syndrome” (counts retrieved 2026-11-04). 981 of them (14.5%) were published from 2020 onward, and the busiest period so far is through 1999 with 2,346 records.
Reviews account for 1,312 records (19.4%) and meta-analyses for 24. Randomized controlled trials number 21 (0.3%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 2,346 |
| 2000-2009 | 1,502 |
| 2010-2019 | 1,939 |
| 2020 onward | 981 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 1,312 | 19.4% |
| Meta-analyses | 24 | 0.4% |
| Randomized controlled trials | 21 | 0.3% |
Method: PubMed query "Hemolytic-Uremic Syndrome"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in kidney, urology and women's health
Kidney, urinary and reproductive health research uses lab markers (such as creatinine), imaging, symptom scores and registry data on pregnancy and birth. Findings about pregnancy are especially sensitive to who was studied and when in pregnancy exposure occurred. Nothing on this page is advice about treatment, fertility or pregnancy; speak to a qualified clinician. Check the population, the outcome measured and whether the study accounted for other health differences between groups.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Treatment Strategies for Infections With Shiga Toxin-Producing Escherichia coli | 2020 | Review article Design not recorded in structured metadata | 70 | cc by PMID 32435624 · DOI · PMC7218068 |
| Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli in children: incidence, risk factors, and clinical outcome | 2020 | Research article Design not recorded in structured metadata | 60 | cc by PMID 32323005 · DOI · PMC7385025 |
| Diagnosis and Treatment for Shiga Toxin-Producing Escherichia coli Associated Hemolytic Uremic Syndrome | 2022 | Review article Design not recorded in structured metadata | 55 | cc by PMID 36668830 · DOI · PMC9862836 |
| Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin-Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025 | 2026 | Research article Design not recorded in structured metadata | 3 | cc by PMID 41986986 · DOI · PMC13094856 |
Treatment Strategies for Infections With Shiga Toxin-Producing Escherichia coli [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Infections with Shiga toxin-producing Escherichia coli (STEC) cause outbreaks of severe diarrheal disease in children and the elderly around the world.
- Closing excerpt
- Here, we review the current understanding of and the progress made in the development of treatment options against STEC infections and discuss their potential.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (149 words)
Infections with Shiga toxin-producing Escherichia coli (STEC) cause outbreaks of severe diarrheal disease in children and the elderly around the world. The severe complications associated with toxin production and release range from bloody diarrhea and hemorrhagic colitis to hemolytic-uremic syndrome, kidney failure, and neurological issues. As the use of antibiotics for treatment of the infection has long been controversial due to reports that antibiotics may increase the production of Shiga toxin, the recommended therapy today is mainly supportive. In recent years, a variety of alternative treatment approaches such as monoclonal antibodies or antisera directed against Shiga toxin, toxin receptor analogs, and several vaccination strategies have been developed and evaluated in vitro and in animal models. A few strategies have progressed to the clinical trial phase. Here, we review the current understanding of and the progress made in the development of treatment options against STEC infections and discuss their potential.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32435624 · DOI · PMC7218068
Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli in children: incidence, risk factors, and clinical outcome [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundHemolytic uremic syndrome (HUS) is a multisystemic disease.
- Closing excerpt
- However, serogroup or stx types did not predict the renal outcome or major CNS symptoms.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (220 words)
BackgroundHemolytic uremic syndrome (HUS) is a multisystemic disease. In a nationwide study, we characterized the incidence, clinical course, and prognosis of HUS caused by Shiga toxin (Stx)-producing Escherichia coli (STEC) strains with emphasis on risk factors, disease severity, and long-term outcome.MethodsThe data on pediatric HUS patients from 2000 to 2016 were collected from the medical records. STEC isolates from fecal cultures of HUS and non-HUS patients were collected from the same time period and characterized by whole genome sequencing analysis.ResultsFifty-eight out of 262 culture-positive cases developed verified (n = 58, 22%) STEC-HUS. Another 29 cases had probable STEC-HUS, the annual incidence of STEC-HUS being 0.5 per 100,000 children. Eleven different serogroups were detected, O157 being the most common (n = 37, 66%). Age under 3 years (OR 2.4), stx2 (OR 9.7), and stx2a (OR 16.6) were found to be risk factors for HUS. Fifty-five patients (63%) needed dialysis. Twenty-nine patients (33%) developed major neurological symptoms. Complete renal recovery was observed in 57 patients after a median 4.0 years of follow-up. Age under 3 years, leukocyte count over 20 × 109/L, and need for dialysis were predictive factors for poor renal outcome.ConclusionsAge under 3 years, stx2, and stx2a were risk factors for HUS in STEC-positive children. However, serogroup or stx types did not predict the renal outcome or major CNS symptoms.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32323005 · DOI · PMC7385025
Diagnosis and Treatment for Shiga Toxin-Producing Escherichia coli Associated Hemolytic Uremic Syndrome [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Shiga toxin-producing Escherichia coli (STEC)-associated hemolytic uremic syndrome (STEC-HUS) is a clinical syndrome involving hemolytic anemia (with fragmented red blood cells), low levels of platelets in the blood (thrombocytopenia), and acute kidney injury (AKI).
- Closing excerpt
- We also summarize preventive and therapeutic strategies for STEC-HUS, such as vaccines, volume expansion, renal replacement therapy (RRT), antibiotics, plasma exchange, antibodies and inhibitors that interfere with receptor binding, and the intracellular trafficking of the Shiga toxin.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (148 words)
Shiga toxin-producing Escherichia coli (STEC)-associated hemolytic uremic syndrome (STEC-HUS) is a clinical syndrome involving hemolytic anemia (with fragmented red blood cells), low levels of platelets in the blood (thrombocytopenia), and acute kidney injury (AKI). It is the major infectious cause of AKI in children. In severe cases, neurological complications and even death may occur. Treating STEC-HUS is challenging, as patients often already have organ injuries when they seek medical treatment. Early diagnosis is of great significance for improving prognosis and reducing mortality and sequelae. In this review, we first briefly summarize the diagnostics for STEC-HUS, including history taking, clinical manifestations, fecal and serological detection methods for STEC, and complement activation monitoring. We also summarize preventive and therapeutic strategies for STEC-HUS, such as vaccines, volume expansion, renal replacement therapy (RRT), antibiotics, plasma exchange, antibodies and inhibitors that interfere with receptor binding, and the intracellular trafficking of the Shiga toxin.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36668830 · DOI · PMC9862836
Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin-Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025 [4]
Abstract reading summary — source excerpts
- Opening excerpt
- In January 2025, the Escherichia coli National Reference Center of France detected an outbreak of hemolytic uremic syndrome (HUS) in adults, caused by Shiga toxin-producing E.
- Closing excerpt
- Related strains have been identified in international databases since 2005, suggesting global emergence.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (151 words)
In January 2025, the Escherichia coli National Reference Center of France detected an outbreak of hemolytic uremic syndrome (HUS) in adults, caused by Shiga toxin-producing E. coli negative for locus of enterocyte effacement (LEE). The outbreak included 18 confirmed cases of E. coli infection, 5 probable or possible cases detected by in-house specific PCR, and 2 additional cases from Scotland and Belgium. Whole-genome sequencing identified the outbreak strain as O77 g:K92:H18, belonging to phylogroup D; the strain harbored the Shiga toxin 2 gene variant stx2d-073-C165-02 and a 134-kb plasmid with enterotoxin genes (estb-STb2 and eltAB). Epidemiologic investigation implicated raw-milk cheese as the contamination source. The strain represents a singular hybrid pathotype of Shiga toxin-producing and enterotoxigenic E. coli, expressing a K92 capsule with known cross-immunogenicity to Neisseria meningitidis group C, which could explain the absence of pediatric cases. Related strains have been identified in international databases since 2005, suggesting global emergence.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41986986 · DOI · PMC13094856
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Atypical hemolytic-uremic syndrome [5]
- Research article An international consensus approach to the management of atypical hemolytic uremic syndrome in children [6]
- Research article Haemolytic uraemic syndrome [7]
- Research article Long-term renal prognosis of diarrhea-associated hemolytic uremic syndrome: a systematic review, meta-analysis, and meta-regression [8]
- Research article STEC-HUS, atypical HUS and TTP are all diseases of complement activation [9]
- Research article Thrombotic Microangiopathy and the Kidney [10]
Full-text reviews on EvidenceLib
Open-access review articles about this topic, reproduced in full with authors, licence and references.
Sepsis-associated disseminated intravascular coagulation and its differential diagnoses
Toshiaki Iba, Eizo Watanabe, Yutaka Umemura et al. · Journal of Intensive Care 2019 · CC BY 4.0
References
- Mühlen S, Dersch P. Treatment Strategies for Infections With Shiga Toxin-Producing Escherichia coli. . 2020. PMID 32435624 · DOI · PMC7218068
- Ylinen E, Salmenlinna S, Halkilahti J, Jahnukainen T, Korhonen L, Virkkala T, et al.. Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli in children: incidence, risk factors, and clinical outcome. . 2020. PMID 32323005 · DOI · PMC7385025
- Liu Y, Liu Y, Thaker H, Wang C, Xu Z, Dong M. Diagnosis and Treatment for Shiga Toxin-Producing Escherichia coli Associated Hemolytic Uremic Syndrome. . 2022. PMID 36668830 · DOI · PMC9862836
- de Larminat J, La K, Bidet P, Birgy A, Liguori S, Phlipaux P, et al.. Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin-Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025. . 2026. PMID 41986986 · DOI · PMC13094856
- Noris M, Remuzzi G. Atypical hemolytic-uremic syndrome. N Engl J Med. 2009. PMID 19846853 · DOI
- Loirat C, Fakhouri F, Ariceta G, Besbas N, Bitzan M, Bjerre A, et al.. An international consensus approach to the management of atypical hemolytic uremic syndrome in children. Pediatr Nephrol. 2016. PMID 25859752 · DOI
- Fakhouri F, Zuber J, Frémeaux-Bacchi V, Loirat C. Haemolytic uraemic syndrome. Lancet. 2017. PMID 28242109 · DOI
- Garg AX, Suri RS, Barrowman N, Rehman F, Matsell D, Rosas-Arellano MP, et al.. Long-term renal prognosis of diarrhea-associated hemolytic uremic syndrome: a systematic review, meta-analysis, and meta-regression. JAMA. 2003. PMID 12966129 · DOI
- Noris M, Mescia F, Remuzzi G. STEC-HUS, atypical HUS and TTP are all diseases of complement activation. Nat Rev Nephrol. 2012. PMID 22986360 · DOI
- Brocklebank V, Wood KM, Kavanagh D. Thrombotic Microangiopathy and the Kidney. Clin J Am Soc Nephrol. 2018. PMID 29042465 · DOI · PMC5967417
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.