haemolytic uraemic syndrome

Question 1

what is the triad for HUS?

Answer 1

AKI
microangiopathic haemolytic anaemia
thrombocytopenia

Question 2

what are the features of HUS?

Answer 2

bloody diarrhoea + abdominal pain

eating undercooked meat

Question 3

what are the types of HUS?

Answer 3

primary- atypical
secondary - typical

Question 4

what is the cause of primary HUS?

Answer 4

complete dysregulation

Question 5

what is the cause of secondary HUS?

Answer 5

shiga toxin-producing Escherichia coli stec O157:H7
-verotoxigenic, enterohaemorrhagic
- leads to endothelial dysfunction

pneumococcal infection
HIV
rare- SLE, drugs, cancer

Question 6

what investigations are needed for HUS?

Answer 6

FBC
- anaemia- microangiopathic haemolytic anemia- hb<80 w negative coombs test
- thrombocytopenia
- fragmented blood film- schistocytes + helmet cells
- normal clotting

UE- AKI

stool culture
- for evidence of STEC infection
- PCR for shiga toxins

Question 7

what is the management of HUS?

Answer 7

supportive- fluids, blood transfusion + dialysis if required

plasma exchange/dialysis for severe cases of HUS not associated with diarrhoea

eculizumab in adult atypical HUS