Hemolytic Uremic Syndrome (HUS)
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Introduction
Hemolytic Uremic Syndrome (HUS) is a microangiopathic hemolytic anemia predominantly affecting children.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
HUS is caused by Shiga toxin, from E Coli 0157:H7. Common sources include:
- contaminated food and water
- unpasturized apple juice
- swimming in dirty swimming pools
Pathophysiology
Signs and Symptoms
- history
- physical exam
History
Physical Exam
Epistaxis, hematuria, hemoptysis, GI bleed
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Renal failure: abnormal urinalyis, oliguria, ARF
CBC and peripheral smear
- PT and PTT normal
- hemolysis: inc uncong bili, LDH, dec haptoglobin
- negative Coombs' test
- BUN, creatinine
stool C and S for pathogenic cause
Diagnostic Imaging
Differential Diagnosis
Treatments
Plasmapheresis and steroids are the treatments of choice. Plasma infusion should be given if plasmapheresis is not immediately available.
Do NOT give platelets, as this can increase rates of intravascular thrombosis.
Consequences and Course
Resources and References
Topic Development
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