Haemolytic Uraemic Syndrome

Question 1

What is this a presentation of?
Recent history of vomiting, bloody diarrhoea before the onset, summer months. Child is unwell, pale or jaundiced with reduced urine output. Triad of acute renal failure, thrombocytopenia, microangiopathic haemolytic anaemia.

Answer 1

Haemolytic uraemic syndrome

Question 2

What are the causes of haemolytic uremic syndrome?

Answer 2

1. More than 90% due to shiga toxin producing E coli, after consumption of contaminated meat.
2. HIV, SLE, cancer, lupus

Question 3

How is haemolytic uraemic syndrome investigated?

Answer 3

1. U&Es - AKI
2. raised LDH
3. FBC, blood film, Coombs negative as not autoimmune
4. stool culture for E coli

Question 4

What is the management for haemolytic uremic syndrome?

Answer 4

1. supportive - IV fluids, blood transfusion, dialysis.

2. eculizumab - anti-C5