Haemolytic uraemic syndrome

Question 1

What is Haemolytic Uraemic Syndrome (HUS)?

Answer 1

HUS involves thrombosis in small blood vessels, usually triggered by Shiga toxins from E. coli O157 or Shigella, often following gastroenteritis, especially in children.

HUS is primarily associated with infections leading to severe complications.

Question 2

What is the classic triad of Haemolytic Uraemic Syndrome (HUS)?

Answer 2

The classic triad of HUS includes:
* Microangiopathic haemolytic anaemia
* Acute kidney injury
* Thrombocytopenia (low platelets)

This triad is essential for clinical diagnosis.

Question 3

How does Haemolytic Uraemic Syndrome (HUS) lead to thrombocytopenia?

Answer 3

The formation of blood clots consumes platelets, leading to thrombocytopenia. Blood flow through the kidneys is affected by thrombi and damaged red blood cells, causing acute kidney injury.

Thrombocytopenia is a key feature of HUS.

Question 4

What is microangiopathic haemolytic anaemia (MAHA)?

Answer 4

MAHA involves the destruction of red blood cells (haemolysis) due to tiny blood clots (thrombi) obstructing small blood vessels, causing red blood cells to rupture as they pass through.

MAHA is a significant component of HUS.

Question 5

How does Haemolytic Uraemic Syndrome (HUS) typically present?

Answer 5

Initial: Diarrhoea (which becomes bloody within 3 days)
After a week:
* Fever
* Abdominal pain
* Lethargy
* Pallor
* Reduced urine output (oliguria)
* Haematuria
* Hypertension
* Bruising
* Jaundice (due to haemolysis)
* Confusion

Recognizing these symptoms is crucial for early diagnosis.

Question 6

What is the risk of using antibiotics and anti-motility medications in gastroenteritis caused by E. coli O157 or Shigella?

Answer 6

Using antibiotics and anti-motility medications (e.g., loperamide) in gastroenteritis caused by these pathogens increases the risk of Haemolytic Uraemic Syndrome (HUS).

This risk highlights the importance of careful management in suspected cases.

Question 7

How is the causative organism of Haemolytic Uraemic Syndrome (HUS) diagnosed?

Answer 7

Stool culture is used to establish the causative organism (e.g., E. coli O157 or Shigella).

Accurate diagnosis is essential for appropriate treatment.

Question 8

What is the management approach for Haemolytic Uraemic Syndrome (HUS)?

Answer 8

Management involves hospital admission and supportive care, including:
* Treatment of hypovolaemia (e.g., IV fluids)
* Managing hypertension
* Severe anaemia (e.g., blood transfusions)
* Severe renal failure (e.g., haemodialysis)

Supportive care is critical for patient recovery.

Question 9

What is the prognosis for most patients with Haemolytic Uraemic Syndrome (HUS)?

Answer 9

HUS is self-limiting, and most patients fully recover with good supportive care.

The prognosis is generally favorable with timely intervention.