Haemolytic Uraemic Syndrome

Question 1

Causes

Answer 1

classically Shiga toxin-producing Escherichia coli 0157:H7 (most common cause in children, accounting for over 90% of cases)

pneumococcal infection

HIV

rare: systemic lupus erythematosus, drugs, cancer

Question 2

Clinical Features

Answer 2

acute kidney injury

microangiopathic haemolytic anaemia

thrombocytopenia

[MAT]

Question 3

Investigations

Answer 3

FBC:

• anaemia
• thrombocytopaenia

U&E:
- acute kidney injury

Blood Film:
- Fragmented

Stool culture

Question 4

Management

Answer 4

• treatment is supportive e.g. Fluids, blood transfusion and dialysis if required
• no role for antibiotics, despite the preceding diarrhoeal illness in many patients
• indications for plasma exchange in HUS are complicated. As a general rule plasma exchange is reserved for severe cases of HUS not associated with diarrhoea
• eculizumab (a C5 inhibitor monoclonal antibody) has evidence of greater efficiency than plasma exchange alone in the treatment of adult atypical HUS