Description

The hemolytic uremic syndrome (HUS) is a condition that can occur when the small blood vessels are damaged and inflamed. This damage can cause the formation of clots in the blood vessels throughout the body. The clots can cause damage to the kidneys and other organs. Hemolytic uremic syndrome can lead to kidney failure, which can be fatal.

Any person can get the hemolytic uremic syndrome. But it is more common in young children. Most often, infection with certain strains of Escherichia coli (E. coli), a bacterium is the cause.

Other infections, certain medications or conditions such as pregnancy, cancer, or autoimmune disease can cause hemolytic uremic syndrome. It can also be the result of certain changes in the genes.

The hemolytic uremic syndrome is severe. But the treatment in time, leading to a full recovery for the majority of people, especially small children.

Symptoms

The symptoms of hemolytic uremic syndrome vary, depending on the cause. The first symptoms of hemolytic uremic syndrome caused by the bacterium E. coli may include:

  • The diarrhea is often bloody.
  • Pain, cramps or swelling in the stomach area.
  • Fever.
  • Vomiting.

All forms of haemolytic uraemic syndrome damage to the blood vessels. This damage causes red blood cells to break down, called anemia. The condition also causes blood clots to form in the blood vessels and, consequently, damage to the kidneys.

The symptoms of these changes include:

  • Loss of color in the skin.
  • Extreme tiredness.
  • Easy bruising.
  • Unusual bleeding, such as bleeding from the nose and mouth.
  • The decreased urination or blood in the urine.
  • Swelling, called edema of the legs, feet or ankles. The swelling occurs less frequently on the face, the hands, the feet or the whole body.
  • Confusion, seizures or a stroke.
  • The high blood pressure.

When to see a doctor

See a member of your health care team right away if you or your child has diarrhea with blood or several days of diarrhea followed by:

  • Urinating less.
  • The swelling.
  • The bruises.
  • Unusual bleeding.
  • Extreme tiredness.

Seek emergency medical attention if you or your child does not urinating for 12 hours or more.

Causes

The most common cause of hemolytic uremic syndrome is an infection with certain strains of the bacterium E. coli. This is especially true for children under the age of 5 years. Some of the strains of E. coli bacteria make a toxin called Shiga toxin. These strains are called Shiga toxin-producing E. coli (STEC).

Most of the hundreds of types of E. coli are typical and harmless. But some E. coli strains can cause hemolytic uremic syndrome.

Other causes of hemolytic uremic syndrome may include:

  • Other infections. This can include infection with pneumococcal bacteria, human immunodeficiency virus (HIV) infection or the flu virus.
  • Certain medications. These may include some of the medicines used to treat cancer and some of the drugs used to keep people receiving donor organs rejection of the organ.
  • Complications of other conditions. Rarely, these conditions may include the pregnancy or conditions such as autoimmune diseases or cancer.

A rare type of hemolytic uremic syndrome, so-called outliers, can be passed down through the families. People who inherit the gene that causes this form of hemolytic uremic syndrome don't always get the condition. But in an infection, the use of certain medications, or ongoing health conditions can start to hemolytic uremic syndrome in people with the gene.

Risk factors

Hemolytic uremic syndrome caused by E. coli can occur if you:

  • Eating meat, fruits or vegetables with the bacteria.
  • Swimming in pools or lakes that have stools with the bacteria.
  • Having close contact with an infected person.

The risk of developing hemolytic uremic syndrome is highest for:

  • Children of 5 years or less.
  • People who have weakened immune systems.
  • People with certain changes in the genes.

Complications

Hemolytic uremic syndrome can cause life-threatening complications, including:

  • Kidney failure, which can be sudden, so-called acute, or happen over time, it is called chronic.
  • The high blood pressure.
  • Stroke or seizures.
  • State of Coma.
  • Blood clotting problems, which can lead to bleeding.
  • The problems of the heart.
  • Digestive tract problems, such as problems with the intestines, gallbladder, or pancreas.

Prevention

The meat or meat products that E. coli does not always look, feel, or smell bad. To protect against the infection of E. coli and other diseases of the food:

  • Do not drink milk, juice or cider that is not processed to make it safe to drink, called pasteurized.
  • Wash hands thoroughly before eating and after using the bathroom or changing diapers.
  • Cleaning the utensils, and surfaces often.
  • Cook the meat to an internal temperature of at least 160 degrees Fahrenheit (71 degrees Celsius).
  • Defrost meat in the microwave or in the refrigerator, not on the table.
  • Keep raw foods separate from other foods. Do not put the meat in the dishes that had raw meat in them.
  • To keep the flesh under produce in the refrigerator to reduce the risk of liquid as the blood that drips on the products.
  • Avoid consuming areas of a bathroom. Do not swim if you have diarrhea.

Diagnosis

A physical examination, and laboratory tests can confirm a diagnosis of hemolytic uremic syndrome. Laboratory tests may include:

  • Blood tests. These tests can show if the red blood cells are damaged. Blood tests may also show a low platelet count, low red blood cell count or a higher level normal waste product that is normally excreted through the kidneys, called creatinine.
  • Urine test. This test can be unusual levels of protein and blood and signs of infection in the urine.
  • Stool sample. This test could find E. coli and other bacteria in the stool.

If the cause of hemolytic uremic syndrome is not clear, other tests may help find the cause.

Treatment

Hemolytic uremic syndrome needs treatment in the hospital. The treatment involves replacing lost fluids and minerals to compensate for the kidneys do not remove fluids and waste as usual. You may also include the pursuit of nutrition through a vein.

Transfusions

In the hospital, you may receive red blood cells or platelets through a vein, a process called a transfusion.

  • Red blood cells can help to counter symptoms of anemia.
  • Platelets may help blood clot best in people who are bleeding or easy bruising.

Medications

Duration renal damage hemolytic uremic syndrome can be treated with a medication to lower the blood pressure. This medication can prevent or delay kidney damage.

For the complications or the atypical form of hemolytic uremic syndrome, the treatment may include a drug called eculizumab (Soliris) to help prevent more damage to the blood vessels.

Any person taking eculizumab need to have a vaccination to prevent meningitis, which is a possible serious side effect of the medicine.

Surgery and other procedures

Depending on the symptoms, the cause of haemolytic uraemic syndrome and if there are complications, treatment may include:

  • The kidney dialysis. Dialysis removes waste and excess fluid from the blood. Dialysis is often done only until the kidneys start to work fine again. But people with a lot of kidney damage may need long-term dialysis.
  • The Plasma exchange. The Plasma is the liquid part of the blood that helps the blood cells and platelets to circulate. Sometimes a machine is used to clean the blood of his own plasma and replace it with fresh or frozen donor plasma.
  • Kidney transplant. Some people who have severe kidney damage of hemolytic uremic syndrome needs a kidney transplant.

Preparing for your appointment

If you or your child has diarrhea for several days, to call someone from your health care team right away. Be ready to answer these questions:

  • Have you seen blood in the diarrhea?
  • Have you or your child has had a fever, swelling, or decreased the production of urine?
  • How much time you have or your child has these symptoms?
  • How long has it been since you or your child urinated?

What you can do in the meantime

If you or your child has an illness that causes vomiting or diarrhea, it will attempt to replace the lost fluids with an oral rehydrating solution such as Ceralyte®, Pedialyte, or Oralyte.

Symptoms and treatment of Hemolytic uremic syndrome (HUS)