Materiały źródłowe

• #1 Interventions for preventing diarrhoea‐associated haemolytic uraemic syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8255341/

  Haemolytic uraemic syndrome (HUS) is a common cause of acquired kidney failure in children and rarely in adults. The most important risk factor for development of HUS is a gastrointestinal infection by Shiga toxin-producing Escherichia coli (STEC). This review addressed the interventions aimed at secondary prevention of HUS in patients with diarrhoea who were infected with a bacteria that increase the risk of HUS. […] Our objective was to evaluate evidence regarding secondary preventative strategies for HUS associated with STEC infections. In doing so, we sought to assess the effectiveness and safety of interventions as well as their potential to impact the morbidity and death associated with this condition. […] Prevention of diarrhoea-associated HUS can be in the form of primary or secondary prevention. Primary prevention relies on identifying and modifying predisposing risk factors for STEC infection, such as food safety, handwashing, and waste disposal. Secondary prevention relies on taking actions to reduce the risk of developing HUS once the predisposing disease, in this case, infectious diarrhoea, has been diagnosed. Some examples of intervention for secondary prevention of HUS include aggressive hydration, antibiotics, monoclonal antibodies against Shiga toxin and Shiga toxin binding proteins (i.e. Synsorb Pk).

• #1 Diagnosis and Treatment for Shiga Toxin-Producing Escherichia coli Associated Hemolytic Uremic Syndrome

  https://www.mdpi.com/2072-6651/15/1/10

  Cutting off the transmission of STEC is the most effective strategy for preventing STEC infections and STEC-HUS. […] On one hand, it is crucial to strengthen the monitoring of STEC contamination in food and water; on the other hand, thorough disinfection and cleaning of hands after any contact are also important. […] Preslaughter interventions can reduce bacterial shedding in animal feces and the contamination of meat and dairy products, to control the spread of this zoonosis. […] Currently, there is no human vaccine against STEC infection. […] The use of different adjuvants such as MALP-2 and Zot in vaccines can also improve their efficacy. […] According to the method of administration, the vaccines can be divided into oral administration, nasal inhalation, subcutaneous administration, abdominal injection, and rectal administration.

• #1 Preventing Shiga toxin-producingandnbsp;E. coli (STEC) and Hemolytic Uremic Syndrome (HUS) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/ecoli/prevention.html

  Wash your hands after using the bathroom and changing diapers, and before handling or eating any food. […] Make sure that persons with diarrhea, especially children, wash their hands carefully and frequently with soap to reduce the risk of spreading the infection. […] Always wash hands after contact with farm animals, animal feces, and animal environments. […] Thoroughly cook raw meat to destroy the bacteria. […] If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking. […] Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties. […] Wash raw fruits and vegetables before eating. […] Keep raw meat separate from produce and other foods when shopping for and storing groceries. […] Wash hands, cutting boards, countertops, cutlery, and utensils after touching raw meat.

• #1 Hemolytic uremic syndrome (HUS) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hemolytic-uremic-syndrome/symptoms-causes/syc-20352399

  Meat or produce that has E. coli won’t always look, feel or smell bad. To protect against E. coli infection and other illnesses from foods: […] Don’t drink milk, juice or cider that isn’t processed to make it safe to drink, called pasteurized. […] Wash hands well before eating and after using the restroom and changing diapers. […] Clean utensils and food surfaces often. […] Cook meat to an inside temperature of at least 160 degrees Fahrenheit (71 degrees Celsius). […] Defrost meat in the microwave or refrigerator, not on the counter. […] Keep raw foods separate from other foods. Don’t put cooked meat on plates that had raw meat on them. […] Store meat below produce in the refrigerator to cut the risk of liquids such as blood dripping on produce. […] Avoid unclean swimming areas. Don’t swim if you have diarrhea.

• #1 Hemolytic Uremic Syndrome (HUS) – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/hemolytic-uremic-syndrome-hus/

  Preventing infection by bacteria, especially E. coli O157:H7, is key to preventing HUS. The following measures can help prevent infection with E. coli O157:H7: […] Never eat rare or undercooked ground beef. […] Cook ground beef to an internal temperature of 160F. […] Keep raw meat separate from ready-to-eat foods. […] Wash hands, counters, utensils, and plates after contact with raw meat. […] Always refrigerate meat products. […] Never leave raw meats at room temperature. […] Do not drink milk, milk products, fruit juices, or ciders that have not been pasteurized. […] Always wash raw fruits or vegetables before eating. […] Make sure children wash their hands carefully, especially after using the toilet or handling or touching animals, especially farm animals. […] Always carefully wash hands with soap and water before and after preparing foods and after using the toilet or changing diapers. […] Do not use public swimming facilities while having diarrhea. […] Clean and disinfect diapering areas, toilets, potty chairs, toys, etc. at least daily and when soiled. […] It is best to stay home when you have diarrhea.

• #1 Preventing Shiga toxin-producingandnbsp;E. coli (STEC) and Hemolytic Uremic Syndrome (HUS) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/ecoli/prevention.html

  Drink only pasteurized milk, juice, or cider. […] Avoid foods made from unpasteurized milk. […] Always wash hands after contact with farm animals, animal feces, and animal environments. […] Children should not attend daycare or preschool with diarrhea. […] Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

• #1 Hemolytic-Uremic Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/982025-followup

  Advise patients to avoid eating raw or partially cooked meat. Improperly cooked or contaminated meat is a potential source of E coli O157:H7. Educate patients on the proper treatment of drinking water. Communities must make adequate efforts to ensure proper treatment and monitoring of drinking water. Educate patients about proper hygienic measures, especially in cattle fields and farms. […] Initial therapy is similar for these conditions. Plasma exchange is the initial treatment of choice in all adult patients with HUS that is not associated with Shiga-like toxin (atypical HUS). Two complement inhibitors, eculizumab and ravulizumab, are approved for the treatment of pediatric and adult patients with atypical HUS. […] Data suggest that familial nonStx-HUS results from genetic abnormalities in the complement regulatory proteins, including C3, factor H, factor B, factor I, and CD46 (membrane cofactor protein, MCP). Factor H appears to be particularly important.

• #1 Hemolytic Uremic Syndrome in Children | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hemolytic-uremic-syndrome-children

  Completely cooking all foods that may contain hamburger meat can prevent HUS that is caused by E. coli. […] If your child has HUS, it is important to notify your daycare center or your child’s other close contacts (for example, play groups and school). HUS is not contagious, but spread of the E. coli bacterium is contagious.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hemolytic-Uremic-Syndrome-Prevention.aspx

  Hemolytic uremic syndrome (HUS) is the major cause of acute renal failure in children. […] Understandably, the prevention of this chain of events is the key to lowering the incidence of HUS, however no specific antidote has yet been found. The measures listed below have been found useful in preventing HUS. The most important action to take is avoidance of any short-term intervention that may finally complicate the course of the disease or result in a worse prognosis. […] Close monitoring of the patient with STEC infections for any signs of HUS is mandatory, including the use of blood tests such as a full blood count and platelet count to detect thrombocytopenia and hemolytic anemia. […] Supportive management is also important. Fluid balance maintenance is crucial in the pre-HUS stage, when there is diarrhea and nausea with or without vomiting, associated with intense colic.

• #1 Hemolytic–uremic syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Hemolytic%E2%80%93uremic_syndrome

  The effect of antibiotics in shiga toxin producing E. coli is unclear. While some early studies raised concerns more recent studies show either no effect or a benefit. […] Early IV fluid hydration is associated with better outcomes including shorter hospital stays and reducing the risk of dialysis. […] Empiric antibiotics are not indicated in those who are immunocompetent, and may worsen the HUS. […] Antidiarrheals and narcotic medications to slow the gut are not recommended as they are associated with worsening symptoms, increased risk of HUS in those with STEC infection, and adverse neurologic reactions. […] Platelet transfusions should not be used as they may drive the process of microangiopathy leading to worsening TTP. […] While eculizumab is being used to treat atypical hemolytic uremic syndrome, no evidence as of 2018 supports its use in the main forms of HUS. Scientists are trying to understand how useful it would be to immunize humans or cattle.

• #1 Hemolytic uremic syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/hemolytic-uremic-syndrome/

  Optimize management of STEC-positive illness, especially in patients with Shiga toxin 2 infection, to prevent progression to HUS. […] Avoid antibiotics, narcotics, and antimotility agents. […] Provide early isotonic IV fluids. […] Reassess daily with clinical evaluation and laboratory studies until symptoms improve and laboratory parameters stabilize. […] Avoid antibiotics and antimotility agents in patients with diarrhea and STEC infection as they can increase the risk of HUS.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hemolytic-Uremic-Syndrome-Prevention.aspx

  Avoidance of antibiotics and antimotility agents in the acute gastroenteritic phase of STEC infection is recommended. […] Thus primary prevention of HUS requires public health recommendations and practices such as: […] Encouraging cattle vaccination to avoid contamination of feces and cattle hide with HUS-causing strains of STEC.

• #1 Hemolytic-Uremic Syndrome Treatment & Management: Medical Care, Consultations, Diet

  https://emedicine.medscape.com/article/201181-treatment

  Because typical HUS commonly occurs in epidemics, consider this possibility and inform health authorities to monitor for the possibility of index cases and to prevent the spread of disease in the community. […] At present, prevention is the main approach to decreasing the morbidity and mortality associated with StxE coli infection. […] Antibiotic treatment of children with E coli O157:H7 infection increases the risk of HUS and should be avoided unless they have septicemia.

• #1 Interventions for Shiga toxin-producing Escherichia coli gastroenteritis and risk of hemolytic uremic syndrome: A population-based matched case control study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263349

  Antibiotics, especially fosfomycin, may prevent the development of HUS in children, while use of antidiarrheal agents should be avoided. […] Evidence supporting treatment intervention, especially the use of antibiotics for STEC infection will provide a proactive strategy in HUS prevention and may reduce morbidity associated with STEC infection. […] The current study results suggest that patients with STEC infection treated with antibiotics, particularly pediatric patients treated with fosfomycin, were at a lower risk of HUS. In contrast, the use of beta-lactam antibiotics and antidiarrheal agents was significantly associated with a higher risk of HUS. […] International and Japanese guidelines for patients with infectious diarrhea clearly state that antidiarrheal drugs should not be used in patients with STEC infection because of the associated increase in the risk of HUS.

• #1

  https://journals.lww.com/10.1681/ASN.2024fmfgwrv7

  During the last decade, it has become increasingly common to diagnose Shiga Toxin Escherichia Coli-related (STEC) infection before Hemolytic Uremic Syndrome (HUS) has developed, providing a potential window of treatment opportunity that, besides generous rehydration, goes underexploited. […] Several in vitro and in vivo studies both on animal models and on humans indicate that azithromycin may be safe and effective in preventing HUS or mitigating disease severity. […] Azithromycin seems safe and may represent a useful therapeutic option in patients with STEC-positive diarrhea to prevent HUS. A controlled study is necessary but, in the meantime, STEC-infected patients should be treated based on the currently available evidence.

• #1

  https://journals.lww.com/md-journal/fulltext/2015/06030/eculizumab_in_typical_hemolytic_uremic_syndrome.36.aspx

  In children with typical HUS and CNS involvement early use of Eculizumab appears to improve neurological outcome. […] We speculate that prophylactic Eculizumab therapy before development of neurological symptoms could be advantageous. […] Our data suggest that early treatment of neurologic symptoms of HUS with Eculizumab can lead to better neurologic outcome than that observed previously using conservative therapy. […] However, in cases of rapidly progressing HUS with multiple organ involvement and delayed start of Eculizumab therapy we observed unsatisfactory outcomes, including 1 death. […] Accordingly, it seems crucial to initiate Eculizumab treatment within hours of the first signs of neurological involvement. […] In conclusion, it can be speculated that in HUS cases with neurologic involvement early Eculizumab therapy could be advantageous in reducing long-term neurological sequelae. […] In patients with rapidly progressing HUS, prophylactic therapy before development of neurological symptoms may be considered.

• #1 Interventions for preventing diarrhoea‐associated haemolytic uraemic syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8255341/

  Use of antibiotics to treat STEC infection to prevent HUS is debatable. The Centers for Disease Control and Prevention and American Gastroenterology Association both recommend against the use of antibiotics to treat STEC to prevent HUS, due to concerns that antibiotic can potentially increase risk of HUS after STEC infection. […] Monoclonal antibodies against Shiga toxins 1 and 2 may be used as a preventative strategy in preventing the onset of HUS. […] The included studies assessed antibiotics, bovine milk, and Shiga toxin inhibitor (Synsorb Pk) and monoclonal antibodies (Urtoxazumab) against Shiga toxin for secondary prevention of HUS in patients with diarrhoea due to STEC. However, no firm conclusions about the efficacy of these interventions can be drawn given the small number of included studies and the small sample sizes of those included studies. Additional studies, including larger multicentre studies, are needed to assess the efficacy of interventions to prevent development of HUS in patients with diarrhoea due to STEC infection.

• #1 Hemolytic Uremic Syndrome: An Emerging Health Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p991.html

  Hemolytic uremic syndrome is the most common cause of acute renal failure in children, and the incidence of this syndrome in children is increasing worldwide. […] All stools should be cultured for STEC when the index of suspicion is high for Escherichia coli O157:H7. […] Do not treat with antibiotics or antidiarrheals while the patient is in the diarrheal stage. […] Because hemolytic uremic syndrome is a reportable disease, local public health officials should be notified. […] The use of antibiotics or antimotility/antidiarrheal and antimicrobial agents in the early stages of diarrhea has been shown to increase the risk of hemolytic uremic syndrome because the gut is exposed to a greater number of toxins for a longer period as intestinal motility slows. […] Antibiotics and antimotility agents are not recommended as treatments for hemolytic uremic syndrome during the diarrheal stage of the disease.

• #1 aHUS (atypical hemolytic uremic syndrome)

  https://www.kidneyfund.org/all-about-kidneys/other-kidney-diseases/ahus-atypical-hemolytic-uremic-syndrome

  Because aHUS is a genetic disease, there is no known way to prevent it. However, treatment can help you manage aHUS. The best way to prevent aHUS from damaging your organs and harming your health is to follow the treatment plan you and your doctors make together.

• #1 Atypical Hemolytic Uremic Syndrome: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/atypical-hemolytic-uremic-syndrome

  Since its most often caused by genetic changes, you usually cant prevent aHUS. If youre at risk for severe illness, you may be able to avoid certain triggers. […] If youve been diagnosed with aHUS, talk to your provider about ways to avoid things that could trigger an episode. Make sure you know what signs and symptoms of severe illness to look out for. […] If youve been diagnosed with aHUS, ask your provider about ways to avoid potential triggers and reduce your risk of severe illness. They can help you understand what tools you need to stay healthy.

• #2 Hemolytic Uremic Syndrome (HUS) – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/hemolytic-uremic-syndrome-hus/

  Preventing infection by bacteria, especially E. coli O157:H7, is key to preventing HUS. The following measures can help prevent infection with E. coli O157:H7: […] Never eat rare or undercooked ground beef. […] Cook ground beef to an internal temperature of 160F. […] Keep raw meat separate from ready-to-eat foods. […] Wash hands, counters, utensils, and plates after contact with raw meat. […] Always refrigerate meat products. […] Never leave raw meats at room temperature. […] Do not drink milk, milk products, fruit juices, or ciders that have not been pasteurized. […] Always wash raw fruits or vegetables before eating. […] Make sure children wash their hands carefully, especially after using the toilet or handling or touching animals, especially farm animals. […] Always carefully wash hands with soap and water before and after preparing foods and after using the toilet or changing diapers. […] Do not use public swimming facilities while having diarrhea. […] Clean and disinfect diapering areas, toilets, potty chairs, toys, etc. at least daily and when soiled. […] It is best to stay home when you have diarrhea.

• #2 Hemolytic Uremic Syndrome in Children

  https://healthinfo.coxhealth.com/library/Wellness/Prevention/90,P03089

  You can help prevent E. coli infection in your family with these steps: […] Be careful when handling raw meat that may contain E. coli. Wash your hands and all surfaces. Dont cross-contaminate clean surfaces. […] Thoroughly cook all foods that may contain E. coli. Hamburger meat is a common source of E. coli. […] Use a meat thermometer when you cook. Make sure the meat reaches at least 160F (71.1C). […] Dont let your child drink unpasteurized juices or milk. […] Have your child wash their hands before eating and after using the bathroom. […] Don’t swim in unclean swimming areas. […] If your child has HUS, tell your daycare center or your child’s other close contacts at play groups and school. HUS is not contagious, but children can spread E. coli bacteria.

• #2 Hemolytic Uremic Syndrome (HUS)

  https://www.health.ny.gov/diseases/communicable/e_coli/hus.htm

  o Always check the temperature of cooked foods with a meat thermometer. Foods that reach the temperatures listed below (or higher) are considered fully cooked. […] 2. Avoid drinking raw (unpasteurized) milk, juices and cider. […] 3. Wash fruits and vegetables thoroughly, especially those that will be eaten raw. […] 4. Wash hands with soap and hot water before and after food preparation, as well as, before eating. […] 5. Wash hands with soap and hot water after using the toilet, changing diapers, and after any animal contact (at home, farms, petting zoos, etc.). […] 6. Do not drink water from untreated sources (including roadside springs) and avoid swallowing water from recreational water sources (including lakes, streams, and swimming pools).

• #2

  https://link.springer.com/article/10.1007/s40124-020-00208-7

  We review the pathophysiology of Shiga-Toxin Enteropathogenic Hemolytic Uremic Syndrome (STEC-HUS), strategies to ameliorate or prevent evolution of STEC-HUS, management and the improved recognition of long-term adverse outcomes. […] Proposed therapies to prevent the development of STEC-HUS have been studied but their efficacy is undetermined. […] The evidence to support IV fluid hydration in the prodromal phase of STEC-HUS continues to grow, yet fluid hydration in at-risk children is not widely practiced. […] There is a need for increased awareness in early identification of E. coli and initiation of IV fluid therapy in primary and secondary care to reduce disease burden globally. […] Best supportive care remains the mainstay of treatment of STEC-HUS in paediatric patients. Volume expansion with isotonic saline may be considered in patients with probable STEC, though use is most effective in the first 4 days of symptoms. […] At present, prevention of STEC infection remains the best strategy for reducing complications of STEC-HUS.

• #2 Hemolytic-Uremic Syndrome Treatment & Management: Medical Care, Consultations, Diet

  https://emedicine.medscape.com/article/201181-treatment

  Because typical HUS commonly occurs in epidemics, consider this possibility and inform health authorities to monitor for the possibility of index cases and to prevent the spread of disease in the community. […] At present, prevention is the main approach to decreasing the morbidity and mortality associated with StxE coli infection. […] Antibiotic treatment of children with E coli O157:H7 infection increases the risk of HUS and should be avoided unless they have septicemia.

• #2 Haemolytic uraemic syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/470

  Adequate hydration is important to minimise renal damage in HUS associated with Shiga toxin-producing E coli infections. Avoidance of antibiotics, antimotility agents, and non-steroidal anti-inflammatory drugs is advised. Cautious use of opioids is advised; there are insufficient data on the effect of opioids on the course of HUS. […] Atypical HUS can occur due to genetic or acquired abnormalities in the alternative complement regulatory pathway. HUS can also occur as a secondary phenomenon due to medications, cancer, and other systemic diseases.

• #2 Hemolytic Uremic Syndrome: An Emerging Health Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p991.html

  Hemolytic uremic syndrome is the most common cause of acute renal failure in children, and the incidence of this syndrome in children is increasing worldwide. […] All stools should be cultured for STEC when the index of suspicion is high for Escherichia coli O157:H7. […] Do not treat with antibiotics or antidiarrheals while the patient is in the diarrheal stage. […] Because hemolytic uremic syndrome is a reportable disease, local public health officials should be notified. […] The use of antibiotics or antimotility/antidiarrheal and antimicrobial agents in the early stages of diarrhea has been shown to increase the risk of hemolytic uremic syndrome because the gut is exposed to a greater number of toxins for a longer period as intestinal motility slows. […] Antibiotics and antimotility agents are not recommended as treatments for hemolytic uremic syndrome during the diarrheal stage of the disease.

• #2 American Society of Nephrology | Kidney Week – Abstract Details (2024)

  https://www.asn-online.org/education/kidneyweek/2024/program-abstract.aspx?controlId=4175770

  Azithromycin for the Prevention of Hemolytic Uremic Syndrome in Shiga Toxin-Positive Diarrhea: A Proof of Concept […] During the last decade, it has become increasingly common to diagnose Shiga Toxin Escherichia Coli-related (STEC) infection before Hemolytic Uremic Syndrome (HUS) has developed, providing a potential window of treatment opportunity that, besides generous rehydration, goes underexploited. Antibiotic treatment is historically contraindicated in Shiga Toxin-positive diarrhea on the assumption that it may trigger STEC-HUS. However, this concept is based on weak evidence mostly concerning bactericidal agents and may not apply to bacteriostatic antibiotics. Several in vitro and in vivo studies both on animal models and on humans indicate that azithromycin may be safe and effective in preventing HUS or mitigating disease severity. […] Azithromycin seems safe and may represent a useful therapeutic option in patients with STEC-positive diarrhea to prevent HUS. A controlled study is necessary but, in the meantime, STEC-infected patients should be treated based on the currently available evidence.

• #2 Case Based Pediatrics Chapter

  https://www.hawaii.edu/medicine/pediatrics/pedtext/s13c05.html

  In atypical HUS, plasmapheresis has been found to be beneficial (11). However, this varies widely depending on the etiology and even the specific genetic mutation involved (3). Eculizumab, an anti-C5 monoclonal antibody, has been FDA approved as a therapy for atypical HUS (2). In the last decade, the use of eculizumab has helped to reduce mortality rates, but up to 50% of patients still develop chronic kidney disease (12).

• #2 Haemolytic Uraemic Syndrome (Causes, Symptoms and Treatment)

  https://patient.info/doctor/haemolytic-uraemic-syndrome-pro

  The organism is very common in cattle and a low level of infection causes clinical disease. Prevention is based on reducing faecal contamination during slaughtering and processing. […] Good personal hygiene measures – eg, hand-washing before and after food-handling and eating, after toilet use and after contact with farm animals. […] Increased public awareness about good food hygiene – eg, cook meat and meat products well, especially where minced or in burger form; avoid cross-contamination between raw and cooked food. […] Early diagnosis enables early supportive treatment and better ultimate prognosis. Similarly, early identification of an outbreak enables public health measures to be put in place to prevent further cases. Separating known cases from their younger siblings may also be an appropriate measure. […] Conjugate vaccines against E. coli O157 are yet to become commercially available.

• #3 Hemolytic–uremic syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Hemolytic%E2%80%93uremic_syndrome

  The effect of antibiotics in shiga toxin producing E. coli is unclear. While some early studies raised concerns more recent studies show either no effect or a benefit. […] Early IV fluid hydration is associated with better outcomes including shorter hospital stays and reducing the risk of dialysis. […] Empiric antibiotics are not indicated in those who are immunocompetent, and may worsen the HUS. […] Antidiarrheals and narcotic medications to slow the gut are not recommended as they are associated with worsening symptoms, increased risk of HUS in those with STEC infection, and adverse neurologic reactions. […] Platelet transfusions should not be used as they may drive the process of microangiopathy leading to worsening TTP. […] While eculizumab is being used to treat atypical hemolytic uremic syndrome, no evidence as of 2018 supports its use in the main forms of HUS. Scientists are trying to understand how useful it would be to immunize humans or cattle.

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