Haemolytic uraemic syndrome

Question 1

Triad of HUS

Answer 1

AKI
microangiopathic haemolytic anaemia
thrombocytopenia

Question 2

HUS is typically seen in which age group?

Answer 2

Children

Question 3

What causes PRIMARY HUS

Answer 3

Complement dysregulation

Question 4

What causes SECONDARY HUS

Answer 4

• Shiga toxin-producing E-coli 0157
• pneumococcal infection
• HIV
• rare: SLE drugs, cancer

Question 5

Investigations used in diagnosis of HUS

Answer 5

FBC
- microangiopathic hemolytic anaemia
- negative Coomb’s test
- thrombocytopenia

Blood film:
- schistocytes and helmet cells

U&E:
- AKI

stool culture
- ?E-Coli 0157 infection

PCR for Shiga toxins

Question 6

Management of HUS

Answer 6

Supportive
- IVF
- transfusion
- dialysis if needed
- plasma exchange if severe
- eculizumab (a C5 inhibitor monoclonal antibody)