HEMOLYTIC-ANEMIA IN ASSOCIATION WITH ESCHERICHIA-COLI-O157 INFECTION IN 2 SISTERS

Two sisters, 2 and 5 years of age, suffered from acute haemolytic anae mia occurring after gastroenteritis with Escherichia coli 0157. One pa tient developed clinical signs of severe and acute intravascular haemo lysis and sepsis. She received transfusion and antibiotic therapy. The second patient presented with mild to moderate haemolytic symptoms on ly. None of them developed renal impairment. In serum of both children , elevated titres of short lived agglutinins were demonstrated in the indirect haemagglutination assay consisting of sheep erythrocytes coat ed with lipopolysaccharide from E. coli 0157. By immunoblot analysis I gM antibodies against the 0157 lipopolysaccharide were demonstrated in the acute phase sera but not in follow up sera taken 2 months after d isease. On erythrocyte membranes, adsorption of microbial antigens was detected by use of a pool-immunoglobulin fluorescence test. The immun ological status of both patients was normal. Complete recovery from ha emolytic disease was observed without further therapy. Microbial antig ens attached to the cell surface were assumed to be the pathophysiolog ical cause of E. coli 0157 associated haemolytic anaemia in two siblin gs.