Feer’s disease is caused by toxicity of:
**Core Concept**
Feer's disease, also known as hemolytic uremic syndrome (HUS), is a complex disorder characterized by the triad of hemolytic anemia, acute kidney injury, and thrombocytopenia. This condition occurs due to the abnormal formation of blood clots in small blood vessels, leading to microangiopathic hemolytic anemia and renal failure.
**Why the Correct Answer is Right**
The correct answer is related to the toxin produced by Shiga-like bacteria, specifically Shigella dysenteriae type 1 and E. coli O157:H7. These bacteria produce a potent toxin called Shiga toxin, which inhibits protein synthesis by cleaving the 28S ribosomal RNA. This action leads to the activation of the coagulation cascade, resulting in the formation of microthrombi and the subsequent development of HUS. The toxin also causes endothelial damage, leading to the release of von Willebrand factor and the formation of platelet thrombi.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify the correct toxin responsible for Feer's disease. While certain toxins can cause hemolytic anemia and renal failure, they are not directly implicated in the pathogenesis of HUS.
**Option B:** This option is incorrect because it refers to a different condition altogether. Hypokalemia can cause renal failure, but it is not directly related to the pathogenesis of HUS.
**Clinical Pearl / High-Yield Fact**
A key feature of HUS is the presence of microangiopathic hemolytic anemia, which is characterized by schistocytes (fragmented red blood cells) on the peripheral smear. This finding is often accompanied by a decrease in platelet count and an increase in serum creatinine.
**Correct Answer:** C. Shiga toxin.