Is Hemolytic Uremic Syndrome?
Hemolytic uremic syndrome (HUS) is a complex condition where
an immune reaction, most commonly after a gastrointestinal tract infection,
causes low red blood cell levels, low platelet levels, and kidney injury.
Infections of the gastrointestinal tract (your stomach and
intestines) are the most common cause of this syndrome. The body’s immune
system reacts to toxins released during an intestinal bacterial infection. This
causes damage and destruction to blood cells as they circulate through the
blood vessels. These include red blood cells (RBC) and platelets, causing them
to die prematurely. The kidney is affected in two ways.The immune reaction can
cause direct damage to kidney cells resulting in kidney injury. Alternatively,
a build-up of destroyed RBCs or platelets can clog up the kidney’s filtering system
and cause kidney injury or a build-up of waste products in the body, since the
kidney can no longer efficiently eliminate waste from the blood.
Kidney injury can be quite serious if left untreated. Kidney
failure, dangerous elevations in blood pressure, heart problems, and stroke are
all concerns if HUS advances without prompt treatment.
HUS is the most common cause of acute kidney failure in
children. It is most common in children under the age of 5, although older
children and adults can also suffer from the disorder.
Fortunately, most people who receive prompt treatment can
make a full recovery without permanent kidney damage.
Symptoms of Hemolytic Uremic Syndrome
The symptoms of HUS vary. Symptoms could include:
bruises or bleeding
in the urine
Causes Hemolytic Uremic Syndrome?
HUS occurs where an immune reaction causes destruction to
blood cells. This results in low red blood cell levels, low platelet levels,
and kidney injury
HUS in Children
The most common underlying cause of HUS in children is infection
with Escherichia Coli (E. coli). There are many different
forms of E. coli, and most do not cause problems. In fact, E.
coli bacteria are normally found in the intestines of healthy people
and animals. However, some specific strains of E. coli, passed on
through contaminated food, are responsible for infections that can lead to HUS.
Bodies of water that are contaminated with feces may also carry E. coli.
Other bacteria such as Shigella dysenteriae and Salmonella
typhi can cause HUS.
HUS in Adults
HUS in adults can also be triggered by infection with E.
coli.. There are also many non-bacterial causes of HUS in adults that are
less common, including:
(used for muscle cramps)
and immunosuppressant medication
lupus and glomerulonephritis
Hemolytic Uremic Syndrome
Some very basic tests can be ordered to determine whether
blood cells have been damaged or kidney function compromised:
A complete blood count (CBC) measures the quantity and
quality of RBCs and platelets in a blood sample.
Other Blood Tests
In order to test for loss of kidney function, your doctor
may order a BUN test (which looks for elevated urea by-products) and creatinine
test (looking for elevated muscle by-products). Abnormal results could indicate
Your doctor will want to test for blood or protein in your
Bacteria or blood in your stool could help your doctor
isolate the underlying cause of your symptoms.
Is Hemolytic Uremic Syndrome Treated?
Common treatments for HUS may include:
The key treatment for HUS is fluid replacement. This treatment
replaces electrolytes that the body needs to function. Electrolytes are
minerals such as calcium, potassium, and magnesium. Fluid replacement also
increases blood flow through the kidneys.. Your doctor will give you
intravenous fluids, but may also encourage you to boost your fluid intake by
drinking more water or electrolyte solutions.
A red blood
transfusion may be necessary if you have a low level of RBCs.
Transfusions are performed in the hospital. Transfusions can relieve symptoms
associated with low RBC counts, such as shortness of breath and extreme
These symptoms are consistent with anemia, a condition in
which your body cannot produce enough red blood cells to supply the body organs
with sufficient oxygen to carry on normal metabolism. This caused by the loss
Your doctor will take you off of any medications that could
be the underlying cause of HUS.
Platelet transfusion may
be necessary if you have a low platelet count.
Plasma exchange is
another form of treatment, in which your doctor replaces your blood plasma with
plasma from a donor. You will receive healthy plasma to support the circulation
of healthy, new red blood cells and platelets.
Are Possible Complications for Hemolytic Uremic Syndrome?
In extreme cases if your kidneys have failed, kidney dialysis may be used to
filter waste from your body. This is a temporary treatment until the kidneys
can function normally. If they do not regain normal function, you may need
a kidney transplant.
The main complication of HUS is kidney failure. However, HUS
can also cause:
Fortunately, most people are able to make a full recovery
What Is the Outlook for Hemolytic Uremic Syndrome?
HUS is potentially a very serious condition. However, you
are likely to make a full recovery if you are diagnosed in the early stages of
the condition and start treatment right away. Call your doctor anytime you
develop symptoms that you are concerned about.
Can You Prevent Hemolytic Uremic Syndrome?
The most common cause of HUS is infections by E.
coli. Although you cannot avoid these bacteria entirely, you can
reduce your risk of infection by:
your hands regularly
food preparation surfaces clean
raw food separate from ready-to-eat food
meat in the refrigerator instead of on the counter
leaving meat at room temperature (this can cause bacterial growth).
meat to 160 degrees Fahrenheit to kill harmful bacteria
fruits and vegetables thoroughly
swimming in contaminated water
ingestion of unpasteurized juice or milk