Hemolytic-Uremic Syndrome and Myocarditis

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Abstract
Two consecutive patients with the hemolytic-uremic syndrome were found to have severe, life-threatening myocardial disease during the acute phase of their illness. In one case, immunofluorescent studies detected the presence of coxsackie B4 viral antigen in the renal tissue, and in the other case, coxsackievirus B4 was isolated from the blood and throat. In both patients, significant neutralizing antibody titer rises to coxsackie B4 antigen were demonstrated. The findings lend further support to the theory that enteroviral infections may play a role in the etiology of at least some cases of the hemolytic-uremic syndrome, and may also be responsible for an associated, severe myocarditis.

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