Hemolytic uremic syndrome (HUS)
Hemolytic uremic syndrome (HUS)
Hemolytic uremic syndrome (HUS) is a condition that results from the abnormal premature destruction of red blood cells. Once this process begins, the damaged red blood cells start to clog the filtering system in the kidneys, which may eventually cause the life-threatening kidney failure associated with hemolytic uremic syndrome.
Most cases of hemolytic uremic syndrome develop in children after two to 14 days of diarrhea — often bloody — due to infection with a certain strain of Escherichia coli (E. coli). Adults also may develop hemolytic uremic syndrome after an E. coli infection, but the cause also may be certain medications, other types of infections, pregnancy or it may be unknown.
Though hemolytic uremic syndrome is a serious condition, getting timely and appropriate treatment leads to a full recovery for most people — especially young children.
Signs and symptoms of hemolytic uremic syndrome may include:
Sometimes neurological symptoms, such as seizures, develop as well.
When to see a doctor
A number of things can cause hemolytic uremic syndrome, but the most common cause — particularly in children — is an infection with a specific strain of E. coli, usually the strain known as O157:H7. However, other strains of E. coli have been linked to hemolytic uremic syndrome, too.
E. coli refers to a group of bacteria normally found in the intestines of healthy humans and animals. Of the hundreds of types of E. coli, most are harmless. But some strains of E. coli are responsible for serious foodborne infections, including those that can lead to hemolytic uremic syndrome. E. coli may be found in:
Most people who are infected with E. coli, even the more dangerous strains, won't develop hemolytic uremic syndrome. It's also possible for hemolytic uremic syndrome to follow infection with other types of bacteria.
In adults, hemolytic uremic syndrome is more commonly caused by other factors, including:
The cause of hemolytic uremic syndrome in adults is often unknown.
Those most at risk of developing hemolytic uremic syndrome are:
Young children and elderly adults are the most likely to be seriously ill from hemolytic uremic syndrome.
Hemolytic uremic syndrome can cause a number of serious, life-threatening complications, including:
Preparing for your appointment
Because most people with hemolytic uremic syndrome are admitted to the hospital after a trip to the emergency room or following a brief phone call or visit with their doctors, it's not likely that you or your child will have a routine office visit.
However, if you or your child is experiencing symptoms of hemolytic uremic syndrome after several days of diarrhea, call your doctor immediately and be prepared to answer these questions:
What you can do in the meantime
Tests and diagnosis
If your doctor suspects hemolytic uremic syndrome, various lab tests may be done to confirm the diagnosis.
Treatments and drugs
Hemolytic uremic syndrome requires treatment in the hospital. To ease immediate signs and symptoms and prevent further problems, hemolytic uremic syndrome treatment may include:
Despite the severity of the condition, appropriate treatment leads to a full recovery for most people with hemolytic uremic syndrome — especially young children.
In those who have some lasting kidney damage, following a low-protein diet and taking the blood pressure lowering medications known as angiotensin-converting enzyme (ACE) inhibitors if blood pressure is high may prevent or delay further kidney damage.
A less common type of hemolytic uremic syndrome called atypical hemolytic uremic syndrome also is treated with plasma exchange. The Food and Drug Administration has approved the use of a medication called eculizumab (Soliris) for the treatment of atypical hemolytic uremic syndrome. Eculizumab is a type of medication known as a monoclonal antibody. It prevents the continued destruction of healthy cells. However, this medication has a significant risk of serious infection. If possible, you or your child may receive the meningococcal vaccine before receiving this medication.
Specific preventive measures for hemolytic uremic syndrome aren't clear. However, it's always a good idea to take precautions against E. coli and other foodborne illnesses. It's important to note that meat or produce contaminated with E. coli won't necessarily look, feel or smell bad. Things you can do that will help reduce your risk of foodborne illness:
Also make sure that everyone in your family — including children — washes his or her hands after using the toilet or changing diapers and before eating. In child care facilities, diapers shouldn't be changed or disposed of in the same room where food is prepared or eaten.
Last Updated: 2013-07-03
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