Flashcards in Hemolytic-Uremic Syndrome Deck (8)
What is hemolytic-uremic syndrom (HUS)? It has 3 components.
An acute syndrome, characterized by microangiopathic hemolytic anemia, thrombocytopenia, and severe renal failure.
What is the pathophysiology behind HUS?
Genetic/chronic disease of complement-mediated thrombotic microangiopathy. Thought that thrombin generation and inhibition of fibrinolysis lead to renal arteriolar and capillary microthrombi.
What is the main cause of HUS in children? What are some of the other causes?
E. coli type 0157:H7 leading cause of HUS. Other causes: drugs, GI bacteria (salmonella, shigella, yersinia), HIV associated thrombotic microangiopathy, pneumococcal infection.
What are clinical presentations of HUS?
Diarrhea precedes HUS (blood 75% of time), abdominal pain, fever, vomiting, somnolence, seize, hepatomegaly and abnormal LFTs, anuria or oliguria
Results of blood test and stool cultures for HUS?
Treatment for HUS?
Largely supportive. Blood transfusions for severe anemia, electrolyte and fluid management, platelet transfusion only for pts w/ sig. bleeding or invasive surgery, PLEX w/ IMA for pts w/ severe CNS involvement, Acute needs- HTN/ seizure control, Chronic- dialysis for anuric or oliguric RF
Causes of mortality in HUS?
Adults with HUS have worse prognosis than children. Causes of mortality: proteinuria, renal insufficiency, HTN.