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Clinical Medicine Heme/Onc > Hemolytic-Uremic Syndrome > Flashcards

Hemolytic-Uremic Syndrome Flashcards

1
Q

What is HUS?

A

An acute syndrome, characterized by

  • Microangiopathic hemolytic anemia
  • Thrombocytopenia
  • Severe renal failure.
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2
Q

HUS epidemiology?

A

Children

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3
Q

HUS is a genetic, life-threatening, chronic disease of… ?

A

Complement-mediated thrombotic microangiopathy

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4
Q

What is the etiology of renal injury in HUS?

A

Thrombin generation and inhibition of fibrinolysis lead to renal arteriolar and capillary microthrombi

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5
Q

What is the etiology of children in HUS?

A

Escherichia coli type 0157:H7

Leading cause of HUS

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6
Q

What are some common causes of HUS in adults and children?

A

Drugs
Infection
HIV
Pneumococcal infection

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7
Q

What is the clinical presentation of HUS?

A 
Diarrhea - 90%
Bloody Diarrhea - 75%
Abdominal Pain 
Vomiting
Fever
Neurologic
Hypertension
Hepatomegaly
Abnormal LFTs
Anuria or oliguria
Glucose intolerance and transient diabetes (10%)
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8
Q

What is diagnostic of HUS?

A

The triad of

  1. Thrombocytopenia
  2. Acute renal failure
  3. Microangiopathic hemolytic anemia
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9
Q

What will a peripheral smear show in HUS?

A

Anemia – (Hgb

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10
Q

What will platelet count show in HUS?

A

Thrombocytopenia (plts usually

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11
Q

What lab tests will be elevated in HUS?

A

Reticulocyte count
LDH
Indirect bilirubin
BUN/creat

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12
Q

What lab test will be low in HUS?

A

Haptoglobin

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13
Q

What lab test will be negative in HUS?

A

Coombs test

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14
Q

What will urinalysis show in HUS?

A

Proteinuria
Microscopic Hematuria
Pyuria

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15
Q

What will a stool culture show in HUS?

A

E. coli 0157:H7

(+) in > 90% during first week of illness

After 1st wk, only 30% are (+)

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16
Q

What is treatment for severe anemia?

A

Blood transfusions

17
Q

What treatment options should be avoided in treatment of HUS?

A

Antibiotics

Antimotility agents

18
Q

What is Eculizumab?

A

A monoclonal antibody toward C5, is approved in adults for tx of atypical HUS

Trials show effectiveness inhibiting complement-mediated thrombotic microangiopathy

19
Q

What is included in acute needs in HUS treatment?

A

HTN

Seizure control

20
Q

What is included in chronic needs in HUS treatment?

A

Dialysis may be required for anuric or oliguric renal failure

21
Q

What is the prognosis in patients with HUS?

A

Adults with HUS have a worse prognosis than do children

Mortality rate is

22
Q

What is important to know for kids testing (+) for the E.coli serotype?

A

They should not return to school or day care facilities until 2 consecutive stools test (-) for the organism.

Clinical Medicine Heme/Onc (11 decks)

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