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Hemolytic-uremic syndrome

  • Definition
    • Shiga-like toxin producing E coli hemolytic-uremic syndrome (STEC-HUS) is a disorder that most often occurs when an infection in the digestive system produces toxic substances. These substances destroy red blood cells and cause kidney injury.

  • Alternative Names
    • HUS; STEC-HUS

  • Causes
    • Hemolytic-uremic syndrome (HUS) often occurs after a gastrointestinal infection with E coli bacteria (Escherichia coli O157:H7). However, the condition has also been linked to other gastrointestinal infections, including shigella and salmonella. It has also been linked to nongastrointestinal infections.

      HUS is most common in children. It is the most common cause of acute kidney failure in children. Several large outbreaks have been linked to undercooked hamburger meat contaminated with E coli.

      STEC-HUS is not to be confused with atypical HUS (aHUS) which is not infection-related. It is similar to another disease called thrombotic thrombocytopenic purpura (TTP).

  • Symptoms
  • Exams and Tests
  • Treatment
    • Treatment may involve:

      • Dialysis
      • Medicines such as corticosteroids
      • Transfusions of packed red blood cells and platelets
  • Outlook (Prognosis)
    • This is a serious illness in both children and adults, and it can cause death. With proper treatment, more than half of people will recover. The outcome is better in children than adults.

  • Possible Complications
  • When to Contact a Medical Professional
    • Call your provider if you develop symptoms of HUS. Emergency symptoms include:

      • Blood in the stool
      • No urination
      • Reduced alertness (consciousness)

      Call your provider if you have had an episode of HUS and your urine output decreases, or you develop other new symptoms.

  • Prevention
    • You can prevent the known cause, E coli, by cooking hamburger and other meats well. You should also avoid contact with unclean water.

  • References
    • Abrams CS. Thrombocytopenia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 172.

      Ruggenenti R, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 35.

      Van Why SK, Avner ED. Hemolytic-uremic syndrome. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 518.