Renal - Haemolytic Uraemic Syndrome Flashcards
What is haemolytic uraemic syndrome?
Thrombosis in small blood vessels caused by Shiga toxins from E.coli O157 or Shigella
What causes haemolytic uraemic syndrome?
Shiga toxins
What can produce Shiga toxin?
E. coli O157
Shigella
Who is affected by haemolytic uraemic syndrome?
Children after episode of gastroenteritis
Why are antibiotics and anti-motility drugs not routinely given for gastroenteritis?
Antibiotics and Loperamide increase the risk of haemolytic uraemic syndrome
What classic triad does haemolytic uraemic syndrome lead to?
Microangiopathic haemolytic anaemia
AKI
Thrombocytopenia (low platelets)
What causes thrombocytopenia and AKI in haemolytic uraemic syndrome?
Formation of blood clots consumes platelets causing thrombocytopenia
Blood flow through the kidney is affected by thrombi and damaged RBCs causing AKI
Why do you get microangiopathic haemolytic anaemia in haemolytic uraemic syndrome?
Destruction of RBCs due to pathology in small vessels (microangiopathy)
Tiny blood clots partially obstruct small blood vessels and churn RBCs as they pass causing them to rupture
How does haemolytic uraemic syndrome present?
E.coli O157 and Shigella cause gastroenteritis
Diarrhoea is the first symptom which turns bloody within 3 days
1 week after onset of diarrhoea the following develop
HAEMOLYTIC
- Hypertension
- Abdominal pain
- fEver
- Macrosopic haematuria
- Oliguria
- Low platelets (bruising)
- Yellow (jaundice)
- Tiredness
- Increasingly pale
- Confusion
How is haemolytic uraemic syndrome managed?
Stool culture to establish causative organism
Medical emergency requires hospital admission and supportive management for:
- Hypovolaemia (IV fluids)
- Hypertension
- Severe anaemia (blood transfusions)
- Severe renal failure (haemodialysis)
Most patients fully recover
