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Hemolytic uremic syndrome

Hemolytic uremic syndrome (HUS) is a medical condition, which is caused due to an abnormal decrease in the blood platelets and red blood cells. The injured blood cells clog the filters in the kidneys, which impairs the elimination of toxic material from the blood. Thus, it may lead to kidney injury or life-threatening kidney failure.

Symptoms

The symptoms of hemolytic uremic syndrome may differ from person to person, which includes:

  • Fever
  • Pale colored skin
  • Bloody diarrhea
  • Decrease in the urine output
  • Blood in urine
  • Abdominal swelling and pain
  • Extreme weakness
  • Irritability
  • Unexplained bleeding and bruising
  • Swelling of face and limbs

Contact the doctor immediately if a person develops any one of the above mentioned symptoms. An emergency medical care is needed if symptoms such as blood in stool, reduced alertness and no urination are present. Immediately contact a doctor if a child does not pass urine for 12 hours.

Causes

Hemolytic uremic syndrome in children occurs mainly due to an infection of the digestive system. As a response to the toxins released by the infectious agents, the human immune system produces certain chemical substances which destroy the blood cells. This can directly or indirectly cause kidney failure.

The most common infection is with E.coli bacteria while the other less common infections include Salmonella and Shigella. Hamburger meat which is not properly cooked is found to be the common source of E.coli.

The other causes of HUS are:

  • Anti-platelet medicines
  • Medicines such as quinine (used for malaria), birth control pills, and chemotherapeutic medicines
  • Glomerulonephritis and systemic lupus
  • Pregnancy
  • Cancer

It is also possible for other family members to get infected with the bacteria and develop hemolytic uremic syndrome.

Risk factors

The risk of hemolytic uremic syndrome is more in the following candidates:

  • Children aged below 5 years
  • Old people (aged above 75 years)
  • People with certain genetic defects

Diagnosis

Physical examination of the patient with hemolytic uremic syndrome may show changes in the nervous system and swelling of the spleen and liver. Simple laboratory tests are enough to detect if there are changes in the blood cells. They include:

Complete blood count (CBC) – this test detects the number and quality of the blood cells.

BUN test and creatinine test – these tests may be ordered to know if the kidney function is altered. Deviations from the normal values indicate an abnormal kidney function.

Urine test – this test is carried out to check for the presence of blood or proteins in the urine.

Stool sample –presence of bacteria and blood may indicate an infection of the digestive tract and give a clue of the underlying cause of HUS.

Treatment

Most of the people who undergo treatment for HUS may have a complete recovery. The most important treatment involves the management of bodily fluids and electrolytes such as magnesium, calcium, and potassium. For this purpose, the doctor prescribes nutritional supplements and intravenous injections. The doctor may also suggest the patient to take more fluids and water.

Blood transfusion may be required if the red blood cell count is too low. It helps to relieve the associated symptoms such as fatigue and shortness of breath.

If the underlying cause of HUS is the use of certain medicines, then the doctor may suggest the patient to discontinue the medicines.

Dialysis is another treatment option. The type of dialysis chosen is based on the individual’s overall health. Most of the patients who undergo dialysis have a complete recovery of their kidney function over a period of time.

Occasionally, a special treatment known as plasmapharesis may be necessary. Plasmapharesis is a method that involves the replacement of the patient’s plasma with the plasma from a healthy donor. This helps to replace the lost blood cells.

Complications

Hemolytic uremic syndrome can lead to the below complications if a prompt treatment is not available:

  • Problems with the clotting of blood
  • Nervous system problems
  • Untreated kidney injury can lead to severe problems such as a dangerously high blood pressure, heart related problems and stroke

Prevention

It is possible to some extent to prevent hemolytic uremic syndrome by washing and cooking meat and food products properly. Also, avoid contact with infected people to prevent the spread of the disease.

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