Haemolytic Uraemic Syndrome Flashcards
What is haemolytic uraemic syndrome.
A combination of haemolysis with red cell fragments, thrombocytopenia and acute renal failure.
What causes haemolytic uraemic syndrome.
Often post-infection.
Classically after pathogenic E.coli O157 (90%).
What are the general signs of haemolytic uraemic syndrome. (3)
Fever (if due to infection).
Malaise.
Lethargy.
Myopathy.
What are the genitourinary sings of haemolytic uraemic syndrome. (3)
Oligouria.
Polyuria.
Nocturia.
What are the dermatological signs of haemolytic uraemic syndrome. (3)
Pruritus.
Rashes.
Purpura.
What are the cardiovascular signs of haemolytic uraemic syndrome. (4)
Raised BP.
Palpitations.
Pericarditis.
Oedema.
What are the GI signs of haemolytic ureamic syndrome. (3)
Nausea. Vomiting. Diarrhoea. Abdominal pain. Hiccough.
What are the respiratory signs of haemolytic ureamic syndrome. (2)
Pulmonary oedema.
Kussmal’s respiration.
What are the CNS signs of haemolytic uraemic syndrome. (3)
Fits.
Peripheral neuropathy.
Encephalopathy.
What is haemolytic ureamic syndrome characterised by.
Microangiopathic haemolytic anaemia (MAHA).
What is MAHA.
Microangiopathic haemolytic anaemia.
Involves intravascular haemolysis and red cell fragmentation.
How does MAHA contribute to the development of haemolytic ureamic syndrome.
Endothelial damage triggers thrombosis, platelet consumption and fibrin strand deposition, mainly in the renal microvasculature.
The strands cause mechanical destruction of passing RBCs.
What results from MAHA. (2)
Thrombocytopenia.
AKI.
Give a summary of the clinical signs of haemolytic ureamic syndrome. (3)
AKI symptoms.
Diarrhoea.
Abdominal pain.
What is seen on a blood film from a patient with haemolytic uraemic syndrome.
Schistocytes.
What is seen on a urine dip stick of a patient with haemolytic uraemic syndrome. (2)
Haematuria/proteinuria.
What is seen on a blood test of a patient with haemolytic uraemic syndrome. (3)
Low platelets.
Los Hb.
Clotting tests are normal.
How is haemolytic ureamic syndrome usually caused. (2)
E.coli O157 infection.
Usually affects children after eating undercooked contaminated meat.
What is the mortality rate for haemolytic ureamic syndrome.
3-5%.
What distinguished haemolytic ureamic syndrome from DIC on blood tests.
In haemolytic ureamic syndrome the clotting tests are all normal.
What is the non-infective cause of haemolytic uraemic syndrome. (2)
Due to a deficiency of complement factor H or complement factor I.
Also called atypical haemolytic uraemic syndrome.
What can sporadic cases of haemolytic ureamic syndrome be associated with. (7)
Pregnancy. SLE. Scleroderma. Malignant hypertension. Metastatic cancer. HIV infection. Various drugs (contraceptive pill, ciclosporin, tacrolimus, chemotherapuetic agents).
