Haemolytic Uraemic Syndrome

• Haemolytic uraemic syndrome (HUS) involves thrombosis in small blood vessels throughout the body, usually triggered by Shiga toxins from either E. coli O157 or Shigella.
• HUS most often affects children following an episode of gastroenteritis.
• Antibiotics and anti-motility medication, such as loperamide, used to treat gastroenteritis caused by E. coli O157 or Shigella, increase the risk of HUS.
• HUS leads to the classic triad of: Microangiopathic haemolytic anaemia, Acute kidney injury, and Thrombocytopenia.
• The formation of blood clots in HUS consumes platelets, leading to thrombocytopenia.
• The first symptom of E. coli O157 and Shigella is diarrhoea, which turns bloody within 3 days.
• Microangiopathic haemolytic anaemia (MAHA) involves the destruction of red blood cells due to pathology in the small vessels (microangiopathy).
• Around a week after the onset of diarrhoea, the features of Haemolytic Uraemic Syndrome (HUS) develop: Fever, Abdominal pain, Lethargy, Pallor, Reduced urine output (oliguria), Haematuria, Hypertension, Bruising, Jaundice (due to haemolysis), Confusion.
• Stool culture is used to establish the causative organism.
• The blood flow through the kidney is affected by thrombi and damaged red blood cells, leading to acute kidney injury.
• Haemolytic Uraemic Syndrome (HUS) is a medical emergency and requires hospital admission and supportive management with treatment of Hypovolaemia, Hypertension, Severe anaemia, Severe renal failure.
• HUS is self-limiting, and most patients fully recover with good supportive care.
• Tiny blood clots (thrombi) partially obstruct the small blood vessels and churn the red blood cells as they pass through, causing them to rupture.