Hemolytic Uremic Syndrome
Hemolytic uremic syndrome (HUS) is a condition that develops as a result of damaged red blood cells that accumulate and clog the filtering system of the kidneys. As a result, blood flow to the kidneys is reduced, damaging kidney function. HUS can affect children and adults, however, most cases of HUS occur in children, and are caused by an infection from E. coli bacteria. Left untreated, HUS can cause serious complications including kidney failure.
Causes of HUS
The E. coli bacteria may cause HUS in children and adults. People may become infected with E. coli after eating contaminated or spoiled meat or produce, or from swimming in contaminated water. Additional causes of HUS in adults may include:
- Pregnancy
- HIV/AID
- Cancer
- Systemic lupus and glomerulonephritis
Certain medications including quinine, chemotherapy drugs, anti-platelet and immunosuppressant medications may also cause HUS in adults. In rare cases, HUS is caused by a genetic condition called atypical hemolytic uremic syndrome, which may be passed down from a parent to a child.
Symptoms of HUS
Most children with HUS experience diarrhea that may contain blood. Additional symptoms may develop and include:
- Pale skin
- Vomiting
- Abdominal pain
- Fatigue
- Fever
- Blood in urine or stool
- Unexplained bruises
HUS may cause the face and limbs to swell and can sometimes lead to confusion or seizures. Parents should seek emergency care if symptoms become severe and if the child has not urinated for 12 hours or more.
Diagnosis of HUS
HUS is diagnosed through a physical examination and review of symptoms. Additional tests may include:
- Blood tests
- Urine tests
- Stool culture
- Kidney biopsy
Diagnostic tests are performed to check for the presence of bacteria and to determine if red blood cells are damaged. Creatinine tests may also be performed to evaluate kidney function.
Treatment of HUS
Initial treatment of HUS focuses on symptom relief and fluid replacement to maintain normal salt and water levels in the body. A red blood cell transfusion may be required if red blood cell counts are low. Depending on the severity of the condition, additional treatment may include:
- Platelet transfusion
- Medication
- Plasma exchange
- Kidney dialysis
Kidney dialysis is often a temporary treatment that is only required until the kidneys start functioning adequately again. Any long term kidney damage may be addressed with a low-protein diet and blood pressure medication. Although HUS can be a serious condition, with prompt and proper treatment, most patients experience a full recovery, especially children.