Haemolytic Uraemic Syndrome

Question 1

Classic triad of symptoms in HUS:

Answer 1

• haemolytic anaemia
• AKI
• Thrombocytopenia (low platelet count)

Question 2

What occurs in HUS

Answer 2

thrombosis in small blood vessels

1. Formation of clots consumes platelets
2. Clots in vessels cause haemolysis - causing anaemia
3. Renal blood flow is affected by clots and damaged RBCs - leading to AKI

Question 3

What toxin causes HUS

Answer 3

Shiga toxin

Question 4

What bacteria produce shiga toxin:

Answer 4

• E.Coli 0157

- Shigella

Question 5

What medications can increase risk of developing HUS

Answer 5

Antibiotics and anti-motility medications such as loperamide

= given to treat the e.coli gastroenteritis

Question 6

Classical presentation of patient with HUS:

Answer 6

• E.coli 0157 - causes brief gastroenteritis (often with bloody diarrhoea)

~5 days after diahrroea ptx. will start displaying symptoms of HUS:

• Reduced urine output
• Haematuria or dark brown urine
• Abdominal pain
• Lethargy and irritability
• Confusion
• Hypertension
• Bruising

Question 7

Management of HUS

Answer 7

Medical emergency (up to 10% mortality)
Condition is self-limiting - therefore supportive management is mainstay

Supportive management:

• antihypertensives
• blood transfusions
• dialysis

Question 8

What proportion of patients with HUS make a full recovery?

Answer 8

70-80%