hemolytic-uremic syndrome

Also known as haemolytic-uraemic syndrome, hemolytic uremic syndrome, Hemolytic-uremic syndrome, HUS, HUS

Human disease

Key facts

Other names: Haemolytic–uraemic syndrome
Specialty: Pediatrics , nephrology
Symptoms: Early: Bloody diarrhea , vomiting , fever Later: Low platelets , low red blood cells , kidney failure
Complications: Neurological problems , heart failure
Types: Shiga toxin–producing E. coli HUS (STEC HUS), S. pneumoniae -associated HUS (SP-HUS), Atypical hemolytic uremic syndrome (aHUS), Cobalamin C HUS
Causes: Infection by E coli O157:H7 , shigella , salmonella
Risk factors: Younger age, female, immunocompromised, or existing renal, urinary, or lower GI disease (because these are the systems involved in the disease)
Differential diagnosis: Thrombotic thrombocytopenic purpura (TTP), disseminated intravascular coagulation (DIC), certain problems with an artificial heart valve
Treatment: Supportive care , dialysis , steroids , blood transfusions , plasmapheresis
Prognosis: <25% long-term kidney problems, which for some of these, could include chronic kidney dysfunction or even failure (which could ultimately need dialysis or transplantation to treat); 5% risk of death during the illness in developed countries with treatment

Article

Hemolytic–uremic syndrome (HUS) is a syndrome characterized by low red blood cells, acute kidney injury (previously called acute renal failure), and low platelets. Initial symptoms typically include bloody diarrhea, fever, vomiting, and weakness. Kidney problems and low platelets then occur as the diarrhea progresses. Children are more commonly affected, but most children recover without permanent damage to their health, although some children may have serious and sometimes life-threatening complications. Adults, especially the elderly, may show a more complicated presentation. Complications may include neurological problems and heart failure.

Most cases occur after infectious diarrhea due to a specific type of E. coli called O157:H7. Other causes include S. pneumoniae, Shigella, Salmonella, and certain medications. The underlying mechanism typically involves the production of Shiga toxin by the bacteria. Atypical hemolytic uremic syndrome (aHUS) is often due to a genetic mutation and presents differently. However, both can lead to widespread inflammation and multiple blood clots in small blood vessels, a condition known as thrombotic microangiopathy.