To the Editor.
—Although the hemolytic-uremic syndrome (HUS) has multiple causes and its pathogenesis remains to be elucidated, the case described by Delans et al,1 like others,2 offers challenge for some suggestions dealing with a common mediator involved in the disease production. As suggested by Delans et al,1 other investigators3-5 have indicated a possible role for endotoxin in the pathogenetic mechanisms of HUS. Since recent data have provided evidence for "endotoxicity" of members of the genus Campylobacter,6,7 it is not unreasonable to indicate the endotoxic lipopolysaccharide of the bacterium as one of the possible determinants of the illness. Clinical studies devoted to identifying circulating endotoxin (as done in HUS after shigellosis4) could confirm the relevance and the value of these suggestions.
Fumarola D, Miragliotta G, Jirillo E. Campylobacter jejuni—Associated Hemolytic-Uremic Syndrome: A Possible Role for Endotoxin. Arch Intern Med. 1985;145(3):573. doi:10.1001/archinte.1985.00360030225041