{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:17:51Z","timestamp":1792156671772,"version":"4.4.0"},"reference-count":90,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Medical Hypotheses"],"published-print":{"date-parts":[[2019,5]]},"DOI":"10.1016\/j.mehy.2019.03.002","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T12:39:33Z","timestamp":1551789573000},"page":"4-8","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"special_numbering":"C","title":["Are Clostridium difficile toxins nephrotoxic?"],"prefix":"10.1016","volume":"126","author":[{"given":"Nevio","family":"Cimolai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.mehy.2019.03.002_b0005","first-page":"371","article-title":"Ten years of prospective Clostridium difficile-associated disease surveillance and treatment at the Minneapolis VA Medical Center, 1982\u20131991","volume":"15","author":"Olson","year":"1994","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.mehy.2019.03.002_b0010","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1146\/annurev.med.49.1.375","article-title":"Clostridium difficile infection","volume":"49","author":"Kelly","year":"1998","journal-title":"Annu Rev Med"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0015","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/S0889-8553(05)70209-0","article-title":"Clostridium difficile","volume":"30","author":"Kyne","year":"2001","journal-title":"Gastroenterol Clin North Am"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0020","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1056\/NEJMcp011603","article-title":"Clinical practice. Antibiotic-associated diarrhea","volume":"346","author":"Bartlett","year":"2002","journal-title":"N Engl J Med"},{"issue":"19","key":"10.1016\/j.mehy.2019.03.002_b0025","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1001\/archinte.162.19.2177","article-title":"The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea","volume":"162","author":"Hurley","year":"2002","journal-title":"Arch Intern Med"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0030","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1128\/CMR.18.2.247-263.2005","article-title":"Clostridium difficile toxins: mechanism of action and role in disease","volume":"18","author":"Voth","year":"2005","journal-title":"Clin Microbiol Rev"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0035","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1574-6976.1994.tb00034.x","article-title":"Toxins A and B of Clostridium difficile","volume":"13","author":"Wolfhagen","year":"1994","journal-title":"FEMS Microbiol Rev"},{"issue":"12","key":"10.1016\/j.mehy.2019.03.002_b0040","doi-asserted-by":"crossref","first-page":"3195","DOI":"10.1111\/j.1572-0241.2008.02198.x","article-title":"Clinical review of the management of fulminant Clostridium difficile infection","volume":"103","author":"Jaber","year":"2008","journal-title":"Am J Gastroenterol"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0045","doi-asserted-by":"crossref","first-page":"621","DOI":"10.2310\/JIM.0b013e3181d5d9e0","article-title":"Optimum timing of blood tests for monitoring patients with Clostridium difficile-associated diarrhea","volume":"58","author":"Bhangu","year":"2010","journal-title":"J Invest Med"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0050","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/S0022-3476(05)81609-9","article-title":"Risk factors for the progression of Escherichia coli O157:H7 enteritis to hemolytic-uremic syndrome","volume":"116","author":"Cimolai","year":"1990","journal-title":"J Pediatr"},{"issue":"12","key":"10.1016\/j.mehy.2019.03.002_b0055","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0051728","article-title":"Five years experience of Clostridium difficile infection in children at a UK tertiary hospital: proposed criteria for diagnosis and management","volume":"7","author":"Pai","year":"2012","journal-title":"PLoS One"},{"key":"10.1016\/j.mehy.2019.03.002_b0060","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1471-2431-14-28","article-title":"Severe clinical outcome is uncommon in Clostridium difficile infection in children: a retrospective cohort study","volume":"14","author":"Schwartz","year":"2014","journal-title":"BMC Pediatr"},{"key":"10.1016\/j.mehy.2019.03.002_b0065","article-title":"Increased age and proton pump inhibitors are associated with severe Clostridium difficile infections in children","author":"Chang","year":"2018","journal-title":"J Microbiol Immunol Infect"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0070","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/ibd\/izx034","article-title":"Clostridium difficile enteropathy is associated with a higher risk for acute kidney injury in patients with an ileostomy: a case-control study","volume":"24","author":"Kochhar","year":"2018","journal-title":"Inflamm Bowel Dis"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0075","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1159\/000330478","article-title":"Acute renal failure in association with community-acquiredClostridiumdifficile infection and McKittrick-Wheelock Syndrome","volume":"5","author":"Learney","year":"2011","journal-title":"Case Rep Gastroenterol"},{"key":"10.1016\/j.mehy.2019.03.002_b0080","article-title":"Acute kidney injury impact on inpatient mortality in Clostridium difficile infection-a national propensity-matched study","author":"Charilaou","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"issue":"8","key":"10.1016\/j.mehy.2019.03.002_b0085","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.3748\/wjg.v11.i8.1245","article-title":"Clostridium difficile causing acute renal failure: case presentation and review","volume":"11","author":"Arrich","year":"2005","journal-title":"World J Gastroenterol"},{"issue":"6","key":"10.1016\/j.mehy.2019.03.002_b0090","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1097\/MCG.0b013e31826af6fd","article-title":"Acute kidney injury is an independent marker of severity in Clostridium difficile infection: a nationwide survey","volume":"47","author":"Khanna","year":"2013","journal-title":"J Clin Gastroenterol"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0095","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1007\/s15010-013-0473-4","article-title":"The impact of pseudomembrane formation on the outcome of Clostridium difficile-associated disease","volume":"41","author":"Berdichevski","year":"2013","journal-title":"Infection"},{"issue":"Pt 9","key":"10.1016\/j.mehy.2019.03.002_b0100","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1099\/jmm.0.058479-0","article-title":"Mortality in patients with Clostridium difficile infection correlates with host pro-inflammatory and humoral immune responses","volume":"62","author":"Solomon","year":"2013","journal-title":"J Med Microbiol"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0105","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2310\/JIM.0b013e3181bca525","article-title":"Laboratory markers as predictors of mortality in patients with Clostridium difficile infection","volume":"58","author":"Pant","year":"2010","journal-title":"J Investig Med"},{"issue":"11","key":"10.1016\/j.mehy.2019.03.002_b0110","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1002\/bjs.8868","article-title":"Systematic review and meta-analysis of outcomes following emergency surgery for Clostridium difficile colitis","volume":"99","author":"Bhangu","year":"2012","journal-title":"Br J Surg"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0115","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/SLA.0b013e31828a8eba","article-title":"Predictors of mortality after emergency colectomy for Clostridium difficile colitis: an analysis of ACS-NSQIP","volume":"259","author":"Lee","year":"2014","journal-title":"Ann Surg"},{"key":"10.1016\/j.mehy.2019.03.002_b0120","doi-asserted-by":"crossref","first-page":"505","DOI":"10.5604\/17322693.1202187","article-title":"Analysis of Clostridium difficile infections in patients hospitalized at the nephrological ward in Poland","volume":"70","author":"Kujawa-Szewieczek","year":"2016","journal-title":"Postepy Hig Med Dosw"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0125","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000351757","article-title":"Renal impairment and clinical outcomes of Clostridium difficile infection in two randomized trials","volume":"38","author":"Mullane","year":"2013","journal-title":"Am J Nephrol"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0130","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1093\/clinids\/18.2.181","article-title":"Clostridium difficile colonization and diarrhea at a tertiary care hospital","volume":"18","author":"Samore","year":"1994","journal-title":"Clin Infect Dis"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0135","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1159\/000484428","article-title":"Clostridium difficile infection in the nephrology ward","volume":"42","author":"Dudzicz","year":"2017","journal-title":"Kidney Blood Press Res"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0140","doi-asserted-by":"crossref","first-page":"152","DOI":"10.7326\/M16-2733","article-title":"Increasing incidence of multiply recurrent Clostridium difficile infection in the United States: a cohort study","volume":"167","author":"Ma","year":"2017","journal-title":"Ann Intern Med"},{"issue":"11","key":"10.1016\/j.mehy.2019.03.002_b0145","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/j.mayocp.2012.05.025","article-title":"Clostridium difficile infection in patients with chronic kidney disease","volume":"87","author":"Keddis","year":"2012","journal-title":"Mayo Clin Proc"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0150","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/BF02054220","article-title":"Severe Clostridium difficile colitis","volume":"38","author":"Rubin","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.mehy.2019.03.002_b0155","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ijid.2017.06.013","article-title":"Impact of end stage kidney disease on costs and outcomes of Clostridium difficile infection","volume":"62","author":"Goyal","year":"2017","journal-title":"Int J Infect Dis"},{"issue":"8","key":"10.1016\/j.mehy.2019.03.002_b0160","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.17219\/acem\/70809","article-title":"Risk factors of the Clostridium difficile infection in patients with chronic kidney disease","volume":"27","author":"Lis","year":"2018","journal-title":"Adv Clin Exp Med"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0165","doi-asserted-by":"crossref","DOI":"10.1111\/tid.12918","article-title":"Risk factors associated with Clostridium difficile infection in kidney transplant recipients","volume":"20","author":"Spinner","year":"2018","journal-title":"Transpl Infect Dis"},{"issue":"9","key":"10.1016\/j.mehy.2019.03.002_b0170","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1097\/TP.0000000000002199","article-title":"Incidence, risk factors, and outcomes of Clostridium difficile infections in kidney transplant recipients","volume":"102","author":"Li","year":"2018","journal-title":"Transplantation"},{"issue":"10","key":"10.1016\/j.mehy.2019.03.002_b0175","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1128\/jcm.25.10.1999-2000.1987","article-title":"Detection of Clostridium difficile toxin in various tissue culture monolayers","volume":"25","author":"Maniar","year":"1987","journal-title":"J Clin Microbiol"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0180","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/0041-0101(92)90538-G","article-title":"Sensitivity in culture of epithelial cells from rhesus monkey kidney and human colon carcinoma to toxins A and B from Clostridium difficile","volume":"30","author":"Torres","year":"1992","journal-title":"Toxicon"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0185","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1074\/jbc.M406014200","article-title":"Clostridium difficile toxin A induces expression of the stress-induced early gene product RhoB","volume":"280","author":"Gerhard","year":"2005","journal-title":"J Biol Chem"},{"issue":"7","key":"10.1016\/j.mehy.2019.03.002_b0190","first-page":"719","article-title":"Comparative study on apoptosis induction of SMMC7721 and Vero cells by Clostridium difficile toxin A","volume":"22","author":"Zhao","year":"2003","journal-title":"Ai Zheng"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0195","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1074\/jbc.271.5.2422","article-title":"Inhibition of receptor signaling to phospholipase D by Clostridium difficile toxin B. Role of Rho proteins","volume":"271","author":"Schmidt","year":"1996","journal-title":"J Biol Chem"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0200","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/BF00853434","article-title":"Haemolytic uraemic syndrome and pseudomembranous colitis","volume":"2","author":"Rooney","year":"1988","journal-title":"Pediatr Nephrol"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0205","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1159\/000190237","article-title":"Hemolytic-uremic syndrome associated with pseudmembranous colitis caused by Clostridium difficile","volume":"76","author":"Mogyorosi","year":"1997","journal-title":"Nephron"},{"issue":"7","key":"10.1016\/j.mehy.2019.03.002_b0210","doi-asserted-by":"crossref","first-page":"3914","DOI":"10.1016\/S0041-1345(98)01287-1","article-title":"Clostridium difficile colitis requiring subtotal colectomy in a renal transplant recipient: a case report and review of literature","volume":"30","author":"Mistry","year":"1998","journal-title":"Transplant Proc"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0215","doi-asserted-by":"crossref","DOI":"10.1016\/S0272-6386(99)70410-5","article-title":"Association of IgA nephropathy with Clostridium difficile colitis","volume":"34","author":"Gaughan","year":"1999","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0220","doi-asserted-by":"crossref","first-page":"E14","DOI":"10.1016\/S0272-6386(03)00210-5","article-title":"Clostridium difficile colitis associated with hemolytic-uremic syndrome","volume":"41","author":"Mbonu","year":"2003","journal-title":"Am J Kidney Dis"},{"issue":"12","key":"10.1016\/j.mehy.2019.03.002_b0225","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1007\/s00467-004-1644-4","article-title":"Hemolytic uremic syndrome associated with Clostridium difficile colitis","volume":"19","author":"Butani","year":"2004","journal-title":"Pediatr Nephrol"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0230","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1053\/j.ajkd.2004.11.026","article-title":"Acute renal failure in a renal allograft: an unusual infectious cause of thrombotic microangiopathy","volume":"46","author":"Sethi","year":"2005","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0235","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1007\/s00467-009-1395-3","article-title":"Hemolytic uremic syndrome in a preterm infant","volume":"25","author":"Kusztrich","year":"2010","journal-title":"Pediatr Nephrol"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0240","article-title":"Hemolytic uremic syndrome and Clostridium difficile colitis","volume":"2","author":"Keshtkar-Jahromi","year":"2012","journal-title":"J Commun Hosp Intern Med Perspect"},{"issue":"9","key":"10.1016\/j.mehy.2019.03.002_b0245","first-page":"586","article-title":"Atypical hemolytic uremic syndrome associated with Clostridium difficile infection and partial membrane cofactor protein (CD46) deficiency","volume":"14","author":"Kalmanovich","year":"2012","journal-title":"Israel Med Assoc J"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0250","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1053\/j.ajkd.2013.09.010","article-title":"Acute oxalate nephropathy associated with Clostridium difficile colitis","volume":"63","author":"Cohen-Bucay","year":"2014","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0255","doi-asserted-by":"crossref","first-page":"302","DOI":"10.5414\/CN107691","article-title":"Hemolytic uremic syndrome associated with Clostridium difficile infection","volume":"81","author":"Alvarado","year":"2014","journal-title":"Clin Nephrol"},{"key":"10.1016\/j.mehy.2019.03.002_b0260","article-title":"A rare cause of reversible renal hemosiderosis","volume":"2015","author":"Abou Arkoub","year":"2015","journal-title":"Case Rep Nephrol"},{"issue":"2018","key":"10.1016\/j.mehy.2019.03.002_b0265","first-page":"1759138","article-title":"Atypical haemolytic uraemic syndrome associated with Clostridium difficile infection successfully treated with eculizumab","volume":"10","author":"Inglis","year":"2018","journal-title":"Case Rep Nephrol"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0270","first-page":"85","article-title":"A continuing assessment of risk factors for the development of Escherichia coli O157:H7-associated hemolytic uremic syndrome","volume":"42","author":"Cimolai","year":"1994","journal-title":"Clin Nephrol"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0275","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/adc.66.1.171-c","article-title":"Gender and the progression of Escherichia coli O157:H7 enteritis to haemolytic uraemic syndrome","volume":"66","author":"Cimolai","year":"1991","journal-title":"Arch Dis Child"},{"issue":"10","key":"10.1016\/j.mehy.2019.03.002_b0280","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1007\/BF01962378","article-title":"Impaired detection of faecal verocytotoxin in the presence of Clostridium difficile cytotoxin in patients with haemolytic uraemic syndrome","volume":"11","author":"Luzzi","year":"1992","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0285","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1136\/adc.69.2.239","article-title":"Clostridium difficile after haemolytic uraemic syndrome","volume":"69","author":"Burgner","year":"1993","journal-title":"Arch Dis Child"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0290","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1159\/000186386","article-title":"IgA nephropathy associated with Campylobacter jejuni enteritis","volume":"58","author":"Carter","year":"1991","journal-title":"Nephron"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0295","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1159\/000189403","article-title":"Hemolytic-uremic syndrome associated with acute Campylobacter upsaliensis gastroenteritis","volume":"74","author":"Carter","year":"1996","journal-title":"Nephron"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0300","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0022-3476(84)80585-5","article-title":"Rapid death of infant rhesus monkeys injected with Clostridium difficile toxins A and B: physiologic and pathologic basis","volume":"104","author":"Arnon","year":"1984","journal-title":"J Pediatr"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0305","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/infdis\/jir748","article-title":"Systemic dissemination of Clostridium difficile toxins A and B is associated with severe, fatal disease in animal models","volume":"205","author":"Steele","year":"2012","journal-title":"J Infect Dis"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0310","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1093\/ajcp\/94.4.410","article-title":"Clostridium difficile invasion and toxin circulation in fatal pediatric pseudomembranous colitis","volume":"94","author":"Qualman","year":"1990","journal-title":"Am J Clin Pathol"},{"issue":"4","key":"10.1016\/j.mehy.2019.03.002_b0315","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/S1344-6223(02)00050-0","article-title":"Pseudomembranous colitis with fatal outcome in a 43-year-old man","volume":"4","author":"T\u00fcrk","year":"2002","journal-title":"Leg Med (Tokyo)"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0320","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1086\/649799","article-title":"Piglet models of acute or chronic Clostridium difficile illness","volume":"201","author":"Steele","year":"2010","journal-title":"J Infect Dis"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0325","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2460\/javma.2002.220.67","article-title":"Characterization of Clostridium difficile isolates from foals with diarrhea: 28 cases (1993\u20131997)","volume":"220","author":"Magdesian","year":"2002","journal-title":"J Am Vet Med Assoc"},{"issue":"14","key":"10.1016\/j.mehy.2019.03.002_b0330","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1001\/jama.1976.03260400017019","article-title":"Unfavorable effect of atropine-diphenoxylate (Lomotil) therapy in lincomycin-caused diarrhea","volume":"235","author":"Novak","year":"1976","journal-title":"J Am Med Assoc"},{"issue":"777","key":"10.1016\/j.mehy.2019.03.002_b0335","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1136\/pgmj.66.777.582-a","article-title":"Loperamide related toxic megacolon in Clostridium difficile colitis","volume":"66","author":"Walley","year":"1990","journal-title":"Postgrad Med J"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0340","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/01.sla.0000236628.79550.e5","article-title":"Impact of emergency colectomy on survival of patients with fulminant Clostridium difficile colitis during an epidemic caused by a hypervirulent strain","volume":"245","author":"Lamontagne","year":"2007","journal-title":"Ann Surg"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0345","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1089\/sur.2017.147","article-title":"Early rescue from acute severe Clostridium difficile: a novel treatment strategy","volume":"19","author":"Kidane","year":"2018","journal-title":"Surg Infect"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0350","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1111\/j.1399-3062.2009.00426.x","article-title":"Systemic absorption of oral vancomycin in a peripheral blood stem cell transplant patient with severe graft-versus-host disease of the gastrointestinal tract","volume":"11","author":"Pogue","year":"2009","journal-title":"Transpl Infect Dis"},{"issue":"12","key":"10.1016\/j.mehy.2019.03.002_b0355","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.jiac.2017.08.004","article-title":"An extremely high bioavailability of orally administered vancomycin in a patient with severe colitis and renal insufficiency","volume":"23","author":"Yamazaki","year":"2017","journal-title":"J Infect Chemother"},{"issue":"11","key":"10.1016\/j.mehy.2019.03.002_b0360","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1097\/00042737-199611000-00004","article-title":"Immune response to Clostridium difficile infection","volume":"8","author":"Kelly","year":"1996","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"2","key":"10.1016\/j.mehy.2019.03.002_b0365","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1128\/iai.62.2.384-389.1994","article-title":"Human antibody response to Clostridium difficile toxin A in relation to clinical course of infection","volume":"62","author":"Warny","year":"1994","journal-title":"Infect Immun"},{"issue":"9251","key":"10.1016\/j.mehy.2019.03.002_b0370","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S0140-6736(00)03592-3","article-title":"Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea","volume":"357","author":"Kyne","year":"2001","journal-title":"Lancet"},{"issue":"7","key":"10.1016\/j.mehy.2019.03.002_b0375","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.vaccine.2003.11.030","article-title":"Active and passive immunization against Clostridium difficile diarrhea and colitis","volume":"22","author":"Giannasca","year":"2004","journal-title":"Vaccine"},{"issue":"Pt 8","key":"10.1016\/j.mehy.2019.03.002_b0380","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1099\/jmm.0.030015-0","article-title":"The host immune response to Clostridium difficile","volume":"60","author":"Kelly","year":"2011","journal-title":"J Med Microbiol"},{"key":"10.1016\/j.mehy.2019.03.002_b0385","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2147\/CEG.S84017","article-title":"An update on antibody-based immunotherapies for Clostridium difficile infection","volume":"9","author":"Hussack","year":"2016","journal-title":"Clin Exp Gastroenterol"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0390","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/MJT.0b013e318245992d","article-title":"Clostridium difficile colitis: review of the therapeutic approach","volume":"21","author":"Joseph","year":"2014","journal-title":"Am J Ther"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0395","doi-asserted-by":"crossref","first-page":"649","DOI":"10.2217\/imt.16.8","article-title":"Effect of passive immunotherapy against Clostridium difficile infection: a systematic review and meta-analysis","volume":"8","author":"Diraviyam","year":"2016","journal-title":"Immunotherapy"},{"key":"10.1016\/j.mehy.2019.03.002_b0400","doi-asserted-by":"crossref","DOI":"10.14309\/crj.2017.64","article-title":"Serum derived bovine immunoglobulin as novel adjunct in complicated Clostridium difficile colitis treatment","volume":"4","author":"Ferm","year":"2017","journal-title":"ACG Case Rep J"},{"issue":"5 Suppl. 1","key":"10.1016\/j.mehy.2019.03.002_b0405","doi-asserted-by":"crossref","first-page":"S289","DOI":"10.1016\/S0016-5085(14)61030-1","article-title":"Serum-derived bovine immunoglobulin\/protein isolate binds and neutralizes Clostridium difficile toxins A and B","volume":"146","author":"Henderson","year":"2014","journal-title":"Gastroenterology"},{"issue":"46","key":"10.1016\/j.mehy.2019.03.002_b0410","doi-asserted-by":"crossref","first-page":"5562","DOI":"10.1016\/j.vaccine.2016.09.046","article-title":"The projected effectiveness of Clostridium difficile vaccination as part of an integrated infection control strategy","volume":"34","author":"van Kleef","year":"2016","journal-title":"Vaccine"},{"issue":"1","key":"10.1016\/j.mehy.2019.03.002_b0415","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.idc.2014.11.013","article-title":"The prospect for vaccines to prevent Clostridium difficile infection","volume":"29","author":"Ghose","year":"2015","journal-title":"Infect Dis Clin North Am"},{"key":"10.1016\/j.mehy.2019.03.002_b0420","doi-asserted-by":"crossref","DOI":"10.1016\/j.cmi.2017.12.022","article-title":"Update of treatment algorithms forClostridiumdifficile infection","author":"Ooijevaar","year":"2018","journal-title":"Clin Microbiol Infect"},{"key":"10.1016\/j.mehy.2019.03.002_b0425","article-title":"Adaptive immune response to Clostridium difficile infection: a perspective for prevention and therapy","author":"Rees","year":"2017","journal-title":"Eur J Immunol"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0430","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1128\/iai.35.3.1147-1150.1982","article-title":"Biological activities of toxins A and B of Clostridium difficile","volume":"35","author":"Lyerly","year":"1982","journal-title":"Infect Immun"},{"issue":"5","key":"10.1016\/j.mehy.2019.03.002_b0435","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1172\/JCI117542","article-title":"Clostridium difficile toxin A-induced microvascular dysfunction: role of histamine","volume":"94","author":"Kurose","year":"1994","journal-title":"J Clin Invest"},{"issue":"6","key":"10.1016\/j.mehy.2019.03.002_b0440","first-page":"548","article-title":"Clostridium difficile infection in adult hamsters","volume":"41","author":"Chang","year":"1991","journal-title":"Lab Anim Sci"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0445","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1177\/030098589503200308","article-title":"Clostridium difficile infection in hamsters fed an atherogenic diet","volume":"32","author":"Blankenship-Paris","year":"1995","journal-title":"Vet Pathol"},{"issue":"3","key":"10.1016\/j.mehy.2019.03.002_b0450","first-page":"743","article-title":"Vascular and glomerular effects of Clostridium difficile toxin A peptide on the isolated rat kidney","volume":"27","author":"Monteiro","year":"1994","journal-title":"Braz J Med Biol Res"}],"container-title":["Medical Hypotheses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0306987719301458?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0306987719301458?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T19:14:44Z","timestamp":1759691684000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0306987719301458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":90,"alternative-id":["S0306987719301458"],"URL":"https:\/\/doi.org\/10.1016\/j.mehy.2019.03.002","relation":{},"ISSN":["0306-9877"],"issn-type":[{"value":"0306-9877","type":"print"}],"subject":[],"published":{"date-parts":[[2019,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Are Clostridium difficile toxins nephrotoxic?","name":"articletitle","label":"Article Title"},{"value":"Medical Hypotheses","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.mehy.2019.03.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}