Hemolytic Uremic Syndrome (HUS)

Question 1

What is the classic triad of Hemolytic Uremic Syndrome?

Answer 1

1. hemolytic anemia
2. Acute Kidney Injury (AKI)
3. Thrombocytopenia

Question 2

What is the main etiology of HUS?

Answer 2

small vessel blood clots in response to Shiga toxin

Question 3

What are the main two bacteria that produce Shiga toxin, like in patients with HUS?

Answer 3

1. Shigella
2. STEC (Shigella-toxin E. coli)

Question 4

What are antibiotics and antimotility drugs not typically used to treat diarrhea in STEC HUS infections?

Answer 4

decreased clearance = increased levels of toxin

breakdown of bacteria releases extra toxin into the body

Question 5

What age group is STEC-HUS typically seen in?

Answer 5

Children < 5 years old

Question 6

Where does STEC typically come from?

Answer 6

Undercooked meats; improperly washed/handled foods (fruits, veggies), water, unpasteurized milk and milk products

Question 7

How long does it take for HUS to develop following prodromal abdominal pain, diarrhea, vomiting?

Answer 7

5-10 days

Question 8

What initial labs should be obtained to help rule in/out HUS? (5)

Answer 8

1. CBC w/diff
2. BMP (BUN/Creatinine)
3. Peripheral Smear
4. Urinalysis
5. Stool screen for STEC

Question 9

What hemoglobin and hematocrit levels would be thresholds for transfusion in patients with HUS?

Answer 9

Hgb < 6 or Hct < 18

Question 10

How long, on average, dose it take the hematologic manifestations of HUS to clear up?

Answer 10

1-2 weeks