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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Almanac of Clinical Medicine</journal-id><journal-title-group><journal-title xml:lang="en">Almanac of Clinical Medicine</journal-title><trans-title-group xml:lang="ru"><trans-title>Альманах клинической медицины</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2072-0505</issn><issn publication-format="electronic">2587-9294</issn><publisher><publisher-name xml:lang="en">Moscow Regional Research and Clinical Institute (MONIKI)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1266</article-id><article-id pub-id-type="doi">10.18786/2072-0505-2020-48-017</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>REVIEW ARTICLE, LECTURE</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОБЗОР, ЛЕКЦИЯ</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">The hemolytic uremic syndrome: a possible etiological role of <italic>Campylobacter</italic> infection</article-title><trans-title-group xml:lang="ru"><trans-title>Гемолитико-уремический синдром. Возможная этиологическая роль инфекции, вызванной <italic>Campylobacter</italic></trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0982-6952</contrib-id><name-alternatives><name xml:lang="en"><surname>Karpovich</surname><given-names>G. S.</given-names></name><name xml:lang="ru"><surname>Карпович</surname><given-names>Г. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold>Gleb S. Karpovich</bold> – MD, Assistant, Chair of Infectious Diseases</p><p>62 Dem'yana Bednogo ul., Novosibirsk, 630005</p><p> Tel.: +7 (913) 725 11 69</p></bio><bio xml:lang="ru"><p><bold>Карпович Глеб Сергеевич</bold> – ассистент кафедры инфекционных болезней</p><p>630005, г. Новосибирск, ул. Демьяна Бедного, 62</p><p>Тел.: +7 (913) 725 11 69</p></bio><email>karpovich.gleb@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3168-9309</contrib-id><name-alternatives><name xml:lang="en"><surname>Krasnova</surname><given-names>E. I.</given-names></name><name xml:lang="ru"><surname>Краснова</surname><given-names>Е. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold>Elena I. Krasnova</bold> – MD, PhD, Professor, Head of the Chair of Infectious Diseases</p><p>52 Krasnyy prospekt, Novosibirsk, 630091</p></bio><bio xml:lang="ru"><p><bold>Краснова Елена Игоревна</bold> – д-р мед. наук, профессор, заведующая кафедрой инфекционных болезней</p><p>630091, г. Новосибирск, ул. Красный проспект, 52</p></bio><email>krasnova-inf@rambler.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4288-5348</contrib-id><name-alternatives><name xml:lang="en"><surname>Vasyunin</surname><given-names>A. V.</given-names></name><name xml:lang="ru"><surname>Васюнин</surname><given-names>А. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold>Aleksandr V. Vasyunin</bold> – MD, PhD, Professor, Chair of Infectious Diseases</p><p>52 Krasnyy prospekt, Novosibirsk, 630091</p></bio><bio xml:lang="ru"><p><bold>Васюнин Александр Васильевич</bold> – д-р мед. наук, профессор кафедры инфекционных болезней</p><p>630091, г. Новосибирск, ул. Красный проспект, 52</p></bio><email>aleksandr.vasyunin1949@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Komissarova</surname><given-names>T. V.</given-names></name><name xml:lang="ru"><surname>Комиссарова</surname><given-names>Т. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold>Tatiana V. Komissarova</bold> – MD, PhD, Head Physician</p><p>81 Okhotskaya ul., Novosibirsk, 630040</p></bio><bio xml:lang="ru"><p><bold>Комиссарова Татьяна Валерьевна</bold> – канд. мед. наук, главный врач</p><p>630040, г. Новосибирск, ул. Охотская, 81</p></bio><email>dgkb3@nso.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Enivatova</surname><given-names>L. I.</given-names></name><name xml:lang="ru"><surname>Ениватова</surname><given-names>Л. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold>Liliya I. Enivatova</bold> – MD, Resuscitator, Head of Intensive Care Unit</p><p>81 Okhotskaya ul., Novosibirsk, 630040</p></bio><bio xml:lang="ru"><p><bold>Ениватова Лилия Ивановна</bold> – врач-реаниматолог, заведующая отделением реанимации и интенсивной терапии</p><p>630040, г. Новосибирск, ул. Охотская, 81</p></bio><email>dgkb3@nso.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Gaynts</surname><given-names>O. V.</given-names></name><name xml:lang="ru"><surname>Гайнц</surname><given-names>О. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold>Oleg V. Gaynts</bold> – MD, Resuscitator, Intensive Care Unit</p><p>81 Okhotskaya ul., Novosibirsk, 630040</p></bio><bio xml:lang="ru"><p><bold>Гайнц Олег Владимирович</bold> – врач-реаниматолог, отделение реанимации и интенсивной терапии</p><p>630040, г. Новосибирск, ул. Охотская, 81</p></bio><email>dgkb3@nso.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Novosibirsk State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Novosibirsk Children's Municipal Clinical Hospital No. 3</institution></aff><aff><institution xml:lang="ru">ГБУЗ НСО «Детская городская клиническая больница № 3»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2020-10-22" publication-format="electronic"><day>22</day><month>10</month><year>2020</year></pub-date><volume>48</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>246</fpage><lpage>253</lpage><history><date date-type="received" iso-8601-date="2020-04-13"><day>13</day><month>04</month><year>2020</year></date><date date-type="accepted" iso-8601-date="2020-04-13"><day>13</day><month>04</month><year>2020</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2020, Karpovich G.S., Krasnova E.I., Vasyunin A.V., Komissarova T.V., Enivatova L.I., Gaynts O.V.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2020, Карпович Г.С., Краснова Е.И., Васюнин А.В., Комиссарова Т.В., Ениватова Л.И., Гайнц О.В.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="en">Karpovich G.S., Krasnova E.I., Vasyunin A.V., Komissarova T.V., Enivatova L.I., Gaynts O.V.</copyright-holder><copyright-holder xml:lang="ru">Карпович Г.С., Краснова Е.И., Васюнин А.В., Комиссарова Т.В., Ениватова Л.И., Гайнц О.В.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://almclinmed.ru/jour/article/view/1266">https://almclinmed.ru/jour/article/view/1266</self-uri><abstract xml:lang="en"><p>Hemolytic uremic syndrome (HUS), one of the forms of thrombotic microangiopathy, is a severe emergency with non-immune (Coombs negative) anemia, thrombocytopenia and acute renal injury. HUS is heterogeneous, and its most common form, the typical HUS, is associated with Shiga toxin (Stx) producing bacteria, such as <italic>Escherichia</italic> <italic>coli</italic>, <italic>Shigella</italic> <italic>dysenteriae</italic>, and <italic>Citrobacter</italic> <italic>freundii</italic>. Less frequent is HUS, caused by a neuraminidase producing streptococcus (pneumococcal HUS). The most uncommon form is the atypical HUS, which is a genetic orphan disease associated with an abnormality in the regulatory protein of the complement system. HUS has a fairly high mortality rate, amounting to 10–15% on average. The long-term outcomes of HUS depend on its type, as well as on the degree of the primary body tissue damage. According to the data from Novosibirsk Children's Municipal Clinical Hospital No 3 from 1991, 44 cases of HUS in children have been identified. Complete recovery, without any residual abnormalities, was registered in 25 children (56.8% of the cases). Nine children (20.5%) developed chronic kidney disease and 10 (22.7%) of all HUS cases were fatal. Early diagnosis, as well as the identification of pathogenetic mechanisms, is the basis for adequate therapy and outcome prediction. <italic>Campylobacter</italic> may be one of the causative agents of HUS. Despite new cases of <italic>Campylobacter</italic>-associated HUS being registered in the world, the very possibility of HUS induction by this pathogen and its pathophysiology are currently unclear. There is no convincing evidence for both Stx and the neuraminidase-related mechanism of HUS in <italic>Campylobacter</italic> infections. Given the high incidence of autoimmune disorders like Guillain-Barre syndrome and reactive arthritis in <italic>Campylobacter</italic> infections, it is currently impossible to exclude an autoimmune mechanism of HUS in these diseases. Thus, the role of <italic>Campylobacter</italic>, as a new potential bacterial agent of HUS, as well as the pathogenesis of such conditions in <italic>Campylobacter</italic> infections, requires further study.</p></abstract><trans-abstract xml:lang="ru"><p>Одна из форм тромботической микроангиопатии гемолитико-уремический синдром (ГУС) представляет собой тяжелую, ургентную патологию, характеризующуюся развитием неиммунной (Кумбс-отрицательной) анемии, тромбоцитопении и острого почечного повреждения. Для ГУС свойственна гетерогенность форм. Наиболее частая форма – типичный ГУС – связана с бактериями, продуцирующими Шига-токсин (Stx), <italic>Escherichia </italic><italic>coli, </italic><italic>Shigella </italic><italic>dysenteriae, </italic><italic>Citrobacter freundii.</italic> Реже встречается ГУС, вызванный стрептококком, продуцирующим нейраминидазу, – пневмококковый ГУС. Наиболее редкая форма – атипичный ГУС, генетическое орфанное заболевание, обусловленное нарушением белка регулятора системы комплемента. ГУС отличается достаточно высокой летальностью, достигающей в среднем 10–15%. Долгосрочный прогноз при ГУС зависит от его типа, а также от глубины первоначального повреждения тканей организма. По данным ГБУЗ НСО ДГКБ № 3 (Новосибирск, Россия), начиная с 1991 г. установлено 44  случая развития ГУС у детей. Полное выздоровление, без развития каких-либо нарушений, зафиксировано у 25 (56,8%) детей, развитие хронической болезни почек отмечено у 9 (20,5%) пациентов, летально завершился ГУС в 10 (22,7%) случаях. Ранняя диагностика, а также выявление патогенетических механизмов лежат в основе адекватной терапии и прогнозирования исходов заболевания. Одним из новых этиологических агентов ГУС может быть <italic>Campylobacter</italic>. Несмотря на то что в мире регистрируются новые случаи ГУС, связанного с <italic>Campylobacter</italic>, на настоящем этапе не ясны ни сама возможность индукции ГУС данным возбудителем, ни патогенез этого состояния. Нет убедительных доказательств как Stx, так и нейраминидазного механизма развития ГУС при кампилобактерных инфекциях. Учитывая высокую частоту развития при инфекциях, вызванных <italic>Campylobacter</italic>, таких аутоиммунных патологий, как синдром Гийена – Барре, реактивные артриты, сегодня не представляется возможным исключить аутоиммунный механизм развития ГУС при этих заболеваниях. Таким образом, роль <italic>Campylobacter</italic> в качестве нового потенциального бактериального агента ГУС, а также патогенез подобных состояний при кампилобактерных инфекциях нуждаются в дальнейшем изучении.</p></trans-abstract><kwd-group xml:lang="en"><kwd>hemolytic uremic syndrome</kwd><kwd>thrombotic microangiopathy</kwd><kwd><italic>Campylobacter</italic></kwd><kwd>acute kidney injury</kwd><kwd>pediatrics</kwd><kwd>infectious diseases</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>гемолитико-уремический синдром</kwd><kwd>тромботическая микроангиопатия</kwd><kwd><italic>Campylobacter</italic></kwd><kwd>острое почечное повреждение</kwd><kwd>педиатрия</kwd><kwd>инфекционные болезни</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>1. Fakhouri F, Vercel C, Frémeaux-Bacchi V. Obstetric nephrology: AKI and thrombotic microangiopathies in pregnancy. 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