Typical hemolytic uremic syndrome: a case report

Shakhmardanov M. Z.¹
Dr. Sci. (Med.), Professor, Department of Infectious Diseases and Epidemiology;
ORCID: 0000-0002-3168-2169; SPIN: 3312-4052

Zykova O. A.¹
Cand. Sci. (Med.), Associate Professor, Department of Infectious Diseases and Epidemiology;
ORCID: 0009-0004-6668-2144; SPIN: 3146-1468

Tomilin Y. N.¹
Cand. Sci. (Med.), Associate Professor, Department of Infectious Diseases and Epidemiology;
ORCID: 0000-0003-2767-4868; SPIN: 8938-2621

Sokhlikov A. A.²
Head of the anesthesiology and resuscitation center;
ORCID: 0009-0007-4447-8232

Leontieva O. A.²
infectious disease specialist;
ORCID: 0009-0003-6377-6498

Burgasova O. A.³⁴
Dr. Sci. (Med.), Professor; Department of Infectious Diseases with Courses in Epidemiology and Phthisiology; Head of the Laboratory of Immunopathogenesis of Infectious Diseases;
ORCID: 0000-0002-5486-0837; SPIN: 5103-0451

Kulagina M. G.⁵
Cand. Sci. (Med.), Associate Professor, Department of Infectious Diseases and Epidemiology;
ORCID: 0000-0003-2587-4911; SPIN: 1854-8601

1Pirogov Russian National Research Medical University, Moscow, Russia
2Infectious Diseases Clinical Hospital No.1 of the Moscow Health Department, Moscow, Russia
3Russian University of Peoples’ Friendship named after Patrice Lumumba
4The National Research Center for Epidemiology and Microbiology named after Honorary Academician N.F. Gamaleya
5Russian University of Medicine

Shakhmardanov M. Z.; e-mail: mur2025@rambler.ru

The authors declare no conflict of interest.

The study had no sponsorship.

10.09.2026

11.09.2026

Hemolytic-uremic syndrome (HUS) is a thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney damage. Typical HUS is most often caused by Shiga toxin, produced by some Escherichia and Shigella. The ability of Shiga toxin to bind to globotriaosylceramide on the surface of target cells (endothelial cells, podocytes, and renal tubular epithelium) leads to acute kidney damage and neurological symptoms. The pathogenesis, clinical manifestations, and treatment of typical GUS are widely discussed in pediatric practice. However, there are only a few reports of typical GUS in older individuals. In this report, we present a clinical case of a 67-year-old patient with a typical HUS who developed an acute intestinal infection of mixed etiology (E. coli + Shigella). We describe the clinical manifestations of the patient's acute intestinal infection. The development of a typical HUS in this patient was accompanied by complications such as bilateral pneumonia, sepsis, and multiple organ failure. The dynamics of hematological parameters showed a significant decrease in the number of red blood cells and platelets, while the levels of creatinine and urea increased. The article describes the treatment methods used to achieve a favorable outcome of the disease. This clinical case illustrates the classic combination of thrombocytopenia, anemia, and uremia in a typical case of GUS, which is accompanied by a severe mixed infection of shigellosis and escherichiosis. Stage 3 hypertension in the observed patient predisposes to the development of complications such as thrombotic microangiopathy. It is hypothesized that the Shiga toxin produced by Enteroinvasive Escherichia coli, which was detected in the patient, triggered the development of HUS in this clinical case. The study concludes that it is necessary to identify elderly individuals with acute intestinal infections caused by Escherichia coli and Shigella.

Hemolytic uremic syndrome, Shiga toxin, escherichia coli infection, shigellosis, case report

10.29234/2308-9113-2026-14-3-166-174

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