{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:16:19Z","timestamp":1788200179412,"version":"build-2803163510"},"reference-count":239,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic E. coli. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea at the forefront. However, in adults, the clinical presentation is more diverse and makes the early diagnosis hazardous. In this review, we review the epidemiology, most important outbreaks, physiopathology, clinical presentation and prognosis of STEC-HUS, focusing on the differential features between pediatric and adult disease. We show that the clinical presentation of STEC-HUS in adults is far from typical and marked by the prevalence of neurological symptoms and a poorer prognosis. Of note, we highlight knowledge gaps and the need for studies dedicated to adult patients. The differences between pediatric and adult patients have implications for the treatment of this disease, which remains a public health threat and lack a specific treatment.<\/jats:p>","DOI":"10.3390\/toxins13050306","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T06:19:11Z","timestamp":1619504351000},"page":"306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7465-6633","authenticated-orcid":false,"given":"Benoit","family":"Travert","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4pital Bichat, Assistance Publique-H\u00f4pitaux de Paris, 75018 Paris, France"},{"name":"Centre de R\u00e9f\u00e9rence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Rafat","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Saint-Antoine, 75012 Paris, France"},{"name":"Urgences N\u00e9phrologiques et Transplantation R\u00e9nale, H\u00f4pital Tenon, Assistance Publique-H\u00f4pitaux de Paris, 75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mariani","sequence":"additional","affiliation":[{"name":"Service de Microbiologie, H\u00f4pital Robert Debr\u00e9, Assistance Publique-H\u00f4pitaux de Paris, 75019 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Cointe","sequence":"additional","affiliation":[{"name":"Service de Microbiologie, H\u00f4pital Robert Debr\u00e9, Assistance Publique-H\u00f4pitaux de Paris, 75019 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Dossier","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4pital Bichat, Assistance Publique-H\u00f4pitaux de Paris, 75018 Paris, France"},{"name":"Centre de R\u00e9f\u00e9rence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Coppo","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Saint-Antoine, 75012 Paris, France"},{"name":"Service d\u2019H\u00e9matologie, H\u00f4pital Saint-Antoine, Assistance Publique-H\u00f4pitaux de Paris, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5278-8966","authenticated-orcid":false,"given":"Adrien","family":"Joseph","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Saint-Antoine, 75012 Paris, France"},{"name":"M\u00e9decine Intensive R\u00e9animation, H\u00f4pital Saint Louis, Assistance Publique-H\u00f4pitaux de Paris, 75010 Paris, France"},{"name":"Centre de Recherche des Cordeliers, \u00c9quipe Labellis\u00e9e par la Ligue Contre le Cancer, Inserm U1138, Universit\u00e9 de Paris, Sorbonne Universit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1056\/NEJMra020528","article-title":"Thrombotic microangiopathies","volume":"347","author":"Moake","year":"2002","journal-title":"N. 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