nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-586Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESГемолитико-уремический синдром, ассоциированный с пневмококковой инфекцией (Обзор литературы)Hemolytic-uremic syndrome associated with pneumococcal infection ReviewКаганМ. Ю.KaganM. Yu.mkaganorenburg@yahoo.comГБУЗ «Областная детская клиническая больница», г. ОренбургРоссияRegional children clinical hospital, OrenburgRussian Federation201320092024152116119Copyright © Каган М.Ю., 20242024Каган М.Ю.Kagan M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/586

Гемолитико-уремический синдром, ассоциированный с пневмококковой инфекцией (ПГУС) – редкая патология, развивающаяся в основном у детей раннего возраста. В этом обзоре представлены современные данные о патофизиологии, клинической картине и методах лечения этого заболевания и обсуждаются трудности диагностики.

Streptococcus pneumonia-associated hemolytic uremic syndrome (HUS) is an uncommon condition mainly observed in young children. This review presents the pathophysiology, clinical features, diagnostic difficulties and management of this condition.

Streptococcus pneumoniaeacute kidney injuryhemolytic uremic syndromeпневмококкострое повреждение почекгемолитико-уремический синдромReferencesAlon U., Adler S.P., Chan J.C. Hemolytic-uremic syndrome associated with Streptococcus pneumoniae. Report of a case and review of the literature // Am. J. Dis. Child. 1984. Vol. 138. P. 496–499.Alon U., Adler S.P., Chan J.C. Hemolytic-uremic syndrome associated with Streptococcus pneumoniae. Report of a case and review of the literature // Am. J. Dis. Child. 1984. Vol. 138. P. 496–499.American Academy of Pediatrics. Therapy for children for invasive pneumococcal infections // Pediatrics. 1997. Vol. 99. P. 289–299.American Academy of Pediatrics. Therapy for children for invasive pneumococcal infections // Pediatrics. 1997. Vol. 99. P. 289–299.Arditi M., Mason E.O. Jr., Bradley J.S. et al. Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use // Pediatrics. 1998. Vol. 102. P. 1087–1097.Arditi M., Mason E.O. Jr., Bradley J.S. et al. Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use // Pediatrics. 1998. Vol. 102. P. 1087–1097.Barit G., Sakarcan A. Antibiotic resistant Streptococcus pneumoniae and hemolytic uremic syndrome // Eur. J. Pediatr. 2005. Vol. 164. P. 414–416.Barit G., Sakarcan A. Antibiotic resistant Streptococcus pneumoniae and hemolytic uremic syndrome // Eur. J. Pediatr. 2005. Vol. 164. P. 414–416.Begue R., Dennehy P.H., Peter G. Hemolytic uremic syndrome associated with Streptococcus pneumonia // N. Engl. J. Med. 1991. Vol. 325. P. 133–134.Begue R., Dennehy P.H., Peter G. Hemolytic uremic syndrome associated with Streptococcus pneumonia // N. Engl. J. Med. 1991. Vol. 325. P. 133–134.Brandt J., Wong C., Mihm S. et al. Invasive pneumococcal disease and hemolytic uremic syndrome // Pediatrics. 2002. Vol. 110. P. 371–376.Brandt J., Wong C., Mihm S. et al. Invasive pneumococcal disease and hemolytic uremic syndrome // Pediatrics. 2002. Vol. 110. P. 371–376.Cabrera G.R., Fortenberry J.D., Warshaw B.L. et al. Hemolytic uremic syndrome associated with invasive Streptococcus pneumoniae infection // Pediatrics. 1998. Vol. 101. P. 699–703.Cabrera G.R., Fortenberry J.D., Warshaw B.L. et al. Hemolytic uremic syndrome associated with invasive Streptococcus pneumoniae infection // Pediatrics. 1998. Vol. 101. P. 699–703.Canadian Pediatric Surveillance Program 2002 Results // Canadian Pediatric Society, Ottawa. 2003. P. 27–28.Canadian Pediatric Surveillance Program 2002 Results // Canadian Pediatric Society, Ottawa. 2003. P. 27–28.Chan J.C.M., Goplerud J.M., Papadopoulou Z.L., Novello A.C. Kidney failure in childhood // Int. J. Pediatr. Nephrol. 1981. Vol. 2. P. 220–221.Chan J.C.M., Goplerud J.M., Papadopoulou Z.L., Novello A.C. Kidney failure in childhood // Int. J. Pediatr. Nephrol. 1981. Vol. 2. P. 220–221.Cochran J.B., Panzarino V.M., Maes L.Y., Tecklenburg F.W. Pneumococcus-induced T-antigen activation in hemolytic uremic syndrome and anemia // Pediatr. Nephrol. 2004. Vol. 19. P. 317–321.Cochran J.B., Panzarino V.M., Maes L.Y., Tecklenburg F.W. Pneumococcus-induced T-antigen activation in hemolytic uremic syndrome and anemia // Pediatr. Nephrol. 2004. Vol. 19. P. 317–321.Constantinescu A.R., Bitzan M., Weiss L.S. et al. Non-enteropathic hemolytic uremic syndrome: causes and short-term course // Am. J. Kidney Dis. 2004. Vol. 43. P. 976–982.Constantinescu A.R., Bitzan M., Weiss L.S. et al. Non-enteropathic hemolytic uremic syndrome: causes and short-term course // Am. J. Kidney Dis. 2004. Vol. 43. P. 976–982.Copelovitch L., Kaplan B.S. Streptococcus pneumonia-associated Hemolytic Uremic Syndrome: Classification and the Emergence of Serotype 19A // Pediatrics. 2010. Vol. 125. P. 174–182.Copelovitch L., Kaplan B.S. Streptococcus pneumonia-associated Hemolytic Uremic Syndrome: Classification and the Emergence of Serotype 19A // Pediatrics. 2010. Vol. 125. P. 174–182.Councilman W.T. An anatomical and bacteriologic study of acute diffuse nephritis // Am. J. Med. Sci. 1897. Vol. 115. P. 23–44.Councilman W.T. An anatomical and bacteriologic study of acute diffuse nephritis // Am. J. Med. Sci. 1897. Vol. 115. P. 23–44.Erickson L.C., Smith W.S., Biswas A.K. et al. Streptococcus pneumoniae-induced hemolytic uremic syndrome: a case for early diagnosis // Pediatr. Nephrol. 1994. Vol. 8. P. 211–213.Erickson L.C., Smith W.S., Biswas A.K. et al. Streptococcus pneumoniae-induced hemolytic uremic syndrome: a case for early diagnosis // Pediatr. Nephrol. 1994. Vol. 8. P. 211–213.Feld L.G., Springate J.E., Darragh R., Fildes R.D. Pneumococcal pneumonia and hemolytic uremic syndrome // Pediatr. Infect. Dis. 1987. Vol. 6. P. 693–695.Feld L.G., Springate J.E., Darragh R., Fildes R.D. Pneumococcal pneumonia and hemolytic uremic syndrome // Pediatr. Infect. Dis. 1987. Vol. 6. P. 693–695.Fischer K., Poschmann A., Oster H. Haemolyse bei schwerer Pneumonie infolge Neuraminidasewirkung // Monatsschr Kinderheilkd. 1971. Vol. 119. P. 2.Fischer K., Poschmann A., Oster H. Haemolyse bei schwerer Pneumonie infolge Neuraminidasewirkung // Monatsschr Kinderheilkd. 1971. Vol. 119. P. 2.Gatter N., Maier O., Hoppe B. Streptococcus pneumonia-induced hemolytic uremic syndrome: report of a further case // Pediatr. Nephrol. 2001. Vol. 16. P. 840–841.Gatter N., Maier O., Hoppe B. Streptococcus pneumonia-induced hemolytic uremic syndrome: report of a further case // Pediatr. Nephrol. 2001. Vol. 16. P. 840–841.Gilbert R.D., Argent A.C. Streptococcus pneumoniae-associated hemolytic uremic syndrome // Pediatr. Infect. Dis J. 1998. Vol. 17. P. 530–532.Gilbert R.D., Argent A.C. Streptococcus pneumoniae-associated hemolytic uremic syndrome // Pediatr. Infect. Dis J. 1998. Vol. 17. P. 530–532.Huang D.T., Chi H., Lee H.C., Chiu N.C., Huang F.Y. T-antigen activation for prediction of pneumococcus-induced hemolytic uremic syndrome and hemolytic anemia // Pediatr. Infect. Dis. J. 2006. Vol. 25. P. 608–610.Huang D.T., Chi H., Lee H.C., Chiu N.C., Huang F.Y. T-antigen activation for prediction of pneumococcus-induced hemolytic uremic syndrome and hemolytic anemia // Pediatr. Infect. Dis. J. 2006. Vol. 25. P. 608–610.Huang Y.H., Lin T.Y., Wong K.S. et al. Hemolytic uremic syndrome associated with pneumococcal pneumonia in Taiwan // Eur. J. Pediatr. 2006. Vol. 165. P. 332–335.Huang Y.H., Lin T.Y., Wong K.S. et al. Hemolytic uremic syndrome associated with pneumococcal pneumonia in Taiwan // Eur. J. Pediatr. 2006. Vol. 165. P. 332–335.Kaplan S.L., Mason E.O. Jr., Basson W.J. et al. Three year multicenter surveillance of systemic pneumococcal infections in children // Pediatrics. 1998. Vol. 102. P. 538–545.Kaplan S.L., Mason E.O. Jr., Basson W.J. et al. Three year multicenter surveillance of systemic pneumococcal infections in children // Pediatrics. 1998. Vol. 102. P. 538–545.Klein P.J., Bulla M., Newman R.A. et al. Thomsen–Friedenreich antigen in haemolyitc-uraemic syndrome // Lancet. 1977. P. 1024–1025.Klein P.J., Bulla M., Newman R.A. et al. Thomsen–Friedenreich antigen in haemolyitc-uraemic syndrome // Lancet. 1977. P. 1024–1025.Krysan D.J., Flynn J.T. Renal transplantation after streptococcus pneumoniae-associated hemolytic uremic syndrome // Am. J. Kidney Dis. 2001. Vol. 37. e15.Krysan D.J., Flynn J.T. Renal transplantation after streptococcus pneumoniae-associated hemolytic uremic syndrome // Am. J. Kidney Dis. 2001. Vol. 37. e15.Lee C.F., Liu S.C., Lue K.H., Chen J.P., Sheu J.N. Pneumococcal pneumonia with empyema and hemolytic uremic syndrome in children: report of three cases // J. Microbiol. Immunol. Infect. 2006. Vol. 39. P. 348–352.Lee C.F., Liu S.C., Lue K.H., Chen J.P., Sheu J.N. Pneumococcal pneumonia with empyema and hemolytic uremic syndrome in children: report of three cases // J. Microbiol. Immunol. Infect. 2006. Vol. 39. P. 348–352.Martinot A., Hue V., Leclerc F., Chenaud M. Haemolyticuraemic syndrome associated with Streptococcus pneumonia meningitis // Eur. J. Pediatr. 1989. Vol. 148. P. 648–649.Martinot A., Hue V., Leclerc F., Chenaud M. Haemolyticuraemic syndrome associated with Streptococcus pneumonia meningitis // Eur. J. Pediatr. 1989. Vol. 148. P. 648–649.Maki N., Komatsuda A., Ohtani H. et al. Streptococcus pneumoniae-associated hemolytic uremic syndrome in a splenectomized adult patient // Intern. Med. 2012. Vol. 51 (15). P. 2001–2005.Maki N., Komatsuda A., Ohtani H. et al. Streptococcus pneumoniae-associated hemolytic uremic syndrome in a splenectomized adult patient // Intern. Med. 2012. Vol. 51 (15). P. 2001–2005.McGraw M.E., Lendon M., Stevens R.F. et al. Haemolytic uremic syndrome and the Thomsen Friendenreich antigen // Pediatr. Nephrol. 1989. Vol. 3. P. 135–139.McGraw M.E., Lendon M., Stevens R.F. et al. Haemolytic uremic syndrome and the Thomsen Friendenreich antigen // Pediatr. Nephrol. 1989. Vol. 3. P. 135–139.McTaggart S.J., Burke J.R. Streptococcus pneumoniae-induced haemolytic uraemic syndrome // J. Paediatr. Child. Health. 1998. Vol. 34. P. 192–195.McTaggart S.J., Burke J.R. Streptococcus pneumoniae-induced haemolytic uraemic syndrome // J. Paediatr. Child. Health. 1998. Vol. 34. P. 192–195.Mizusawa Y., Pitcher L.A., Burke J.R., Falk M.C., Mizushima W. Survey of haemolytic-uraemic syndrome in Queensland 1979–1995 // Med. J. Aust. 1996. Vol. 165. P. 188–191.Mizusawa Y., Pitcher L.A., Burke J.R., Falk M.C., Mizushima W. Survey of haemolytic-uraemic syndrome in Queensland 1979–1995 // Med. J. Aust. 1996. Vol. 165. P. 188–191.Moorthy B., Makker S.P. Hemolytic-uremic syndrome associated with pneumococcal sepsis // J. Pediatr. 1979. Vol. 95. P. 558–559.Moorthy B., Makker S.P. Hemolytic-uremic syndrome associated with pneumococcal sepsis // J. Pediatr. 1979. Vol. 95. P. 558–559.Myers K.A., Marrie T.J. Thrombotic microangiopathy associated with Streptococcus pneumoniae bacteremia: case report and review // Clin. Infect. Dis. 1993. Vol. 17. P. 1037–1040.Myers K.A., Marrie T.J. Thrombotic microangiopathy associated with Streptococcus pneumoniae bacteremia: case report and review // Clin. Infect. Dis. 1993. Vol. 17. P. 1037–1040.Nathanson S., Deschenes G. Prognosis of Streptococcus pneumoniae-induced hemolytic uremic syndrome // Pediatr. Nephrol. 2001. Vol. 16. P. 362–365.Nathanson S., Deschenes G. Prognosis of Streptococcus pneumoniae-induced hemolytic uremic syndrome // Pediatr. Nephrol. 2001. Vol. 16. P. 362–365.Novak R.W., Martin C.R., Orsini E.N. Hemolytic-uremic syndrome and T-cryptantigen exposure by neuraminidase-producing pneumococci: an emerging problem? // Pediatr. Pathol. 1983. Vol. 1. P. 409–413.Novak R.W., Martin C.R., Orsini E.N. Hemolytic-uremic syndrome and T-cryptantigen exposure by neuraminidase-producing pneumococci: an emerging problem? // Pediatr. Pathol. 1983. Vol. 1. P. 409–413.Pan C.G., Leichter H.E., Werlin S.L. Hepatocellular injury in Streptococcus pneumoniae-associated hemolytic uremic syndrome in children // Pediatr. Nephrol. 1995. Vol. 9. P. 690–693.Pan C.G., Leichter H.E., Werlin S.L. Hepatocellular injury in Streptococcus pneumoniae-associated hemolytic uremic syndrome in children // Pediatr. Nephrol. 1995. Vol. 9. P. 690–693.Petras M.L., Dunbar N.M., Filiano J.J. et al. Therapeutic plasma exchange in Streptococcus pneumoniae-associated hemolytic uremic syndrome: a case report // J. Clin. Apher. 2012. Vol. 27 (4). P. 212–214.Petras M.L., Dunbar N.M., Filiano J.J. et al. Therapeutic plasma exchange in Streptococcus pneumoniae-associated hemolytic uremic syndrome: a case report // J. Clin. Apher. 2012. Vol. 27 (4). P. 212–214.Proulx F., Sockett P. Prospective surveillance of Canadian children with the haemolytic uraemic syndrome // Pediatr. Nephrol. 2005. Vol. 20. P. 786–790.Proulx F., Sockett P. Prospective surveillance of Canadian children with the haemolytic uraemic syndrome // Pediatr. Nephrol. 2005. Vol. 20. P. 786–790.Sajjanhar T., Mayer A., Murdoch I.A. Chronic subdural haematoma and Streptococcus pneumoniae-associated haemolytic-uraemic syndrome // Acta. Paediatr. 1996. Vol. 85. P. 1135–1136.Sajjanhar T., Mayer A., Murdoch I.A. Chronic subdural haematoma and Streptococcus pneumoniae-associated haemolytic-uraemic syndrome // Acta. Paediatr. 1996. Vol. 85. P. 1135–1136.Schenk E.A., Panke T.W., Cole H.A. Glomerular and arteriolar thrombosis in pneumococcal septicemia // Arch. Pathol. 1970. Vol. 89. P. 154–159.Schenk E.A., Panke T.W., Cole H.A. Glomerular and arteriolar thrombosis in pneumococcal septicemia // Arch. Pathol. 1970. Vol. 89. P. 154–159.Seger R., Joller P., Baerlocher K. et al. WHHaemolytic-uremic syndrome associated with neuraminidase-producing microorganisms: treatment by exchange transfusion // Helv. Paediatr. Acta. 1980. Vol. 35. P. 359–367.Seger R., Joller P., Baerlocher K. et al. WHHaemolytic-uremic syndrome associated with neuraminidase-producing microorganisms: treatment by exchange transfusion // Helv. Paediatr. Acta. 1980. Vol. 35. P. 359–367.Siegler R.L. Hemolytic uremic syndrome in children // Curr Opin Pediatr. 1995. Vol. 7. P. 159–163.Siegler R.L. Hemolytic uremic syndrome in children // Curr Opin Pediatr. 1995. Vol. 7. P. 159–163.Siegler R., Oakes R. Hemolytic uremic syndrome; pathogenesis, treatment, and outcome // Curr. Opin. Pediatr. 2005. Vol. 17. P. 200–204.Siegler R., Oakes R. Hemolytic uremic syndrome; pathogenesis, treatment, and outcome // Curr. Opin. Pediatr. 2005. Vol. 17. P. 200–204.Siegler R.L., Pavia A.T., Christofferson R.D., Milligan M.K. A 20 year population based study of post-diarreal hemolytic uremic syndrome in Utah // Pediatrics. 1994. Vol. 94. P. 35.Siegler R.L., Pavia A.T., Christofferson R.D., Milligan M.K. A 20 year population based study of post-diarreal hemolytic uremic syndrome in Utah // Pediatrics. 1994. Vol. 94. P. 35.Vanderkooi O.G., Kellner J.D., Wade A.W. et al. Invasive Streptococcus pneumonia infection causing hemolytic uremic syndrome in children: two recent cases // Can. J. Infect. Dis. 2003. Vol. 14. P. 339–343.Vanderkooi O.G., Kellner J.D., Wade A.W. et al. Invasive Streptococcus pneumonia infection causing hemolytic uremic syndrome in children: two recent cases // Can. J. Infect. Dis. 2003. Vol. 14. P. 339–343.Vierbuchen M., Klein P.J. Histochemical demonstration of neuraminidase effects in pneumococcal meningitis // Lab. Invest. 1983. Vol. 48. P. 181–186.Vierbuchen M., Klein P.J. Histochemical demonstration of neuraminidase effects in pneumococcal meningitis // Lab. Invest. 1983. Vol. 48. P. 181–186.von Eyben F.E., Szpirt W. Pneumococcal sepsis with hemolytic-uremic syndrome in the adult // Nephron. 1985. Vol. 40. P. 501–502.von Eyben F.E., Szpirt W. Pneumococcal sepsis with hemolytic-uremic syndrome in the adult // Nephron. 1985. Vol. 40. P. 501–502.von Vigier R.O., Seibel K., Bianchetti M.G. Positive Coombs test in pneumococcus-associated hemolytic uremic syndrome: a review of the literature // Nephron. 1999. Vol. 82. P. 183–184.von Vigier R.O., Seibel K., Bianchetti M.G. Positive Coombs test in pneumococcus-associated hemolytic uremic syndrome: a review of the literature // Nephron. 1999. Vol. 82. P. 183–184.von Vigier R.O., Fossali E., Crosazzo L., Bianchetti M.G. Positive Coombs test in postpneumococcal hemolytic-uremic syndrome // Pediatr. Infect. Dis. J. 2005. Vol. 24. P. 1028–1029.von Vigier R.O., Fossali E., Crosazzo L., Bianchetti M.G. Positive Coombs test in postpneumococcal hemolytic-uremic syndrome // Pediatr. Infect. Dis. J. 2005. Vol. 24. P. 1028–1029.Yahav J., Aladjem M., Boichis H., Barzilay Z. Hemolytic uremic syndrome due to pneumococcal sepsis // Int. J. Pediatr. Nephrol. 1980. Vol. 1. P. 197–198.Yahav J., Aladjem M., Boichis H., Barzilay Z. Hemolytic uremic syndrome due to pneumococcal sepsis // Int. J. Pediatr. Nephrol. 1980. Vol. 1. P. 197–198.

The authors declare that there are no conflicts of interest present.