The Journal of Medical Microbiology, Vol 48, Issue 1 11-16, Copyright © 1999 by Society for General Microbiology
Antibodies to Shiga toxin in the serum of children with Shigella-associated haemolytic uraemic syndrome
T. Azim, A. Rashid, F. Qadri, M. S. Sarker, J. Hamadani, M. A. Salam, M. A. Wahed and M. J. Albert
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Antibodies to Shiga toxin (Stx) were measured in the sera of 49 children
with Shigella dysenteriae serotype 1 infection, of whom 17 had haemolytic
uraemic syndrome (HUS) and 32 had no complications (uncomplicated
shigellosis, UCS). Children with HUS had lower levels of total IgG and IgM
and lower IgM titres to Stx than those with UCS. The number of children
with neutralising antibodies was similar in the two groups. Of the children
with HUS, 11 had HUS on enrolment and six developed HUS subsequent to
enrolment. Antibody titres in children who subsequently developed HUS were
compared with those in children with UCS to assess whether differences in
antibody titres occurred before the development of HUS. IgA titres to Stx
were found to be higher in children who subsequently developed HUS than in
those with UCS. However, logistic regression analysis revealed that titres
of Stx antibodies in the serum were not significant risk factors for the
development of HUS. Thus, although the levels of Stx antibodies were
different in children with HUS, and higher IgA titres to Stx were
identifiable in children who subsequently developed HUS compared with those
with UCS, the relevance of these findings in the development of HUS remains
to be elucidated.
