Hemolytic uremic syndrome

Hemolytic uremic syndrome: Description, Causes and Risk Factors: Hemolytic uremic syndromeHemolytic uremic syndrome is a disease that destroys red blood cells (RBC), is the most common cause of sudden, short-term-acute-kidney failure in children. Although hemolytic uremic syndrome can cause serious complications and can even be life threatening, most children who develop hemolytic uremic syndrome recover without permanent damage to their health. While the cause of hemolytic uremic syndrome has not been established with certainty, researchers believe that an abnormal inflammation reaction is stimulated in the blood stream causing platelets (the parts of the blood that form clots) to sludge in small blood vessels and form blood clots where they are not supposed to. This uses up the platelets and causes a shortage of them in the rest of the body. This abnormal reaction may be caused by a yet unidentified chemical that is produced in blood plasma (the fluid or non-cellular part of the bloodstream). Hemolytic uremic syndrome develops when Escherichia coli (E. coli) bacteria lodged in the digestive tract make toxins that enter the bloodstream and start to destroy red blood cells. Most cases of hemolytic uremic syndrome occur after an infection of the digestive tract by the E. coli bacterium, which is found in foods like meat, dairy products, and juice when they are contaminated. Some people have contracted hemolytic uremic syndrome after swimming in pools or lakes contaminated with feces. Infection of the digestive tract is called gastroenteritis and may cause a child to vomit and have stomach cramps and bloody diarrhea. Most children who have gastroenteritis recover fully in 2 or 3 days and do not develop hemolytic uremic syndrome. Other risk factors may include: Children under 5 years of age.
  • People who have weakened immune systems.
  • Adults older than 60 years of age.
  • People who have certain genetic changes that make them more susceptible.
  • Pregnancy and the early postpartum (after delivery) time period and the use of birth control pills are the more common associations with Hemolytic uremic syndrome.
  • Pneumonia caused by the Streptococcus pneumoniae bacteria is another possible precipitating factor. Hemolytic uremic syndrome is rare complication of this common infection. Most often, this pneumonia is treated with antibiotics as an outpatient.
  • Medications may be also associated with HUS, including some chemotherapy and immunosuppression drugs, birth control pills.
Hemolytic uremic syndrome in children tends to be self-limiting, and full recovery should be expected. Adults do less well. Without aggressive therapy like plasmapheresis and dialysis, up to 40% of those affected may die, and 80% may have kidney impairment. With treatment, the death rate falls to 10% or less and kidney impairment to 25%. Symptoms: Signs and symptoms of hemolytic uremic syndrome may include: Vomiting.
  • Abdominal pain.
  • Bloody diarrhea.
  • Pale skin tone.
  • Fatigue and irritability.
  • Fever, usually not high.
  • Small, unexplained bruises or bleeding from the nose and mouth.
  • Decreased urination or blood in the urine.
  • Swelling of the face, hands, feet or entire body.
  • Confusion.
Sometimes neurological symptoms, such as seizures, develop as well. Diagnosis: If your doctor suspects hemolytic uremic syndrome, various lab tests may be done to confirm the diagnosis. Tests may include: Urine test. Your doctor may also collect a urine sample to test for blood in your urine.
  • Blood tests. Blood tests may reveal a low platelet count, low red blood cell count or a higher than normal level of creatinine — a breakdown product of creatine, an important part of muscle — in your blood. A blood sample can also be used to determine if your red blood cells are damaged.
  • Stool sample. Additionally, your doctor may take a stool sample to test for the presence of bacteria.
Treatment: Treatments, which consist of maintaining normal salt and water levels in the body, are aimed at easing the immediate symptoms and preventing further problems. General treatment options may include: Fluid replacement. Lost fluid and electrolytes need to be carefully replaced because the kidneys aren't removing fluids and waste as efficiently as normal.
  • Red blood cell transfusions. If you don't have enough red blood cells, you may feel chilled, fatigued and short of breath. You may have a rapid heart rate, yellow skin and dark urine. Red blood cell transfusions, given through an intravenous (IV) needle, may help reverse these signs and symptoms.
  • Platelet transfusions. If you're bleeding or bruising easily, platelet transfusions can help your blood clot more normally. Like red blood cell transfusions, platelet transfusions are given through an IV needle.
  • Plasma exchange. Plasma is the part of blood that supports the circulation of blood cells and platelets. Sometimes a machine is used to clear the blood of its own plasma and replace it with fresh or frozen donor plasma. This process is called plasmapheresis.
  • Kidney dialysis. Sometimes dialysis is needed to filter waste and excess fluid from the blood. Dialysis is usually a temporary treatment until the kidneys begin functioning adequately again. If the kidney damage is significant, however, permanent kidney failure — requiring long-term dialysis or a kidney transplant — is possible.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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