hemolytic-uremic syndrome

hemolytic-uremic syndrome (HUS)Dr. Nariman fahmipediatric/2014

objectives

Definition Classifications Pathogenesis Clinical manifestations Diagnosis management

Definition The most common cause of acute renal failure in young children It is classically characterized by the triad of microangiopathic hemolytic anemia Thrombocytopenia uremia

classifications

Typical HUS Atypical HUS


Hemorrhagic E. coli (O157:H7) is a different strain of E.coli that causes serious intestinal illness in humans. E. Coli is killed when meats are cooked thoroughly.

eating contaminated milk, cheese,Iettuce

Diarrhea form is usually transmitted by undercooked meat or unpasteurized milk

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The diagnosis is supported by the findings of a microangiopathic hemolytic anemia thrombocytopenia and acute renal failure


Renal manifestations vary from -Mild renal insufficiency -Acute oliguric or Anuric renal failure requiring dialysis.


COMPLICATIONS Anemia Acidosis Hyperkalemia Fluid overload Heart failure Hypertension Uremia.

Extra renal manifestations

Central nervous system dysfunction includes irritability, seizures, coma. Gastrointestinal manifestations ischemic or inflammatory colitis, intestinal perforation, intussusception acute pancreatitis Arrhythmias ,others

Early institution of dialysis

Blood transfusion for symptomatic anemia
management

Management

Blood transfusion for symptomatic anemia control of hypertension meticulous attention to fluid and electrolytes Early institution of dialysis NO Antibiotic therapy for E. coli 0157: H7 it will increase risk of HUS

prognosis

With aggressive management of acute renal failure more than 90% of patients survive the acute phase of HUS with a diarrheal prodrome.



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