PLASMA P-SELECTIN IN CHILDREN WITH HEMOLYTIC UREMIC SYN-DROME CAUSED BY ESCHERICHIA COLI O157 : H7

Abstract

Microvascular thrombosis in the kidney plays an important role in the pathogenesis of hemolytic uremic syndrome (HUS). To evaluate the pathophysiological significance of the plasma levels of P-selectin, which is releared from activated or damaged endthelial cells, we measured the plasma concentrations of this protein in children with HUS associated with verotoxin-producing Escherichia coli (VTEC). In the acute phase of HUS, plasma levels of P-selectin were significantly higher than those in non-HUS or healthy controls, and returned to normal range in the recovery phase. The elevated levels of plasma P-selectin were found to correlate with an increase in soluble thrombomodulin and thrombin antithrombin Ⅲ complex, implying an association between platelet activation, endothelial cell injury and activation of the coagulation cascade. However, there was no definite correlation between P-selectin levels and platelet counts or serum creatinine levels. From these findings, we concluded that the elevation of elevated circulating P-selectin levels in HUS associated with VTEC infection is related to endothelial cell injury and platelet activation as a primary event, and its measurement may be helpful for an early diagnosis of this disease.