Hemolytic-uremic syndrome (HUS) is a disorder that usually occurs when an infection in the digestive system produces toxic substances that destroy red blood cells, causing kidney injury.
Causes, incidence, and risk factors
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
HUS is most common in children. It is the most common cause of acute kidney failure in children. Several large outbreaks in 1992 and 1993 were linked to undercooked hamburger meat contaminated with E. coli.
Other risk factors for HUS are unknown, although some cases are due to a familial form of the disease. HUS may occur with a variety of other diseases and infections, and after taking certain medications such as mitomycin C or ticlopidine.
HUS is more complicated in adults. It is similar to another disease called
HUS often begins with vomiting and diarrhea, which may be bloody. Within a week, the person may become weak and irritable. Persons with this condition may urinate less than normal. Urine output may almost stop.
Red blood cell destruction leads to symptoms of
Blood in the stools
Fever Lethargy Vomitingand diarrhea Weakness
Bruising Decreased consciousness Low urine output No urine output Pallor Seizures— rare
- Skin rash that looks like fine red spots (
- Yellow skin (jaundice)
Signs and tests
The health care provider will perform a physical exam. This may show:
Liver or spleen swelling
Nervous system changes
Laboratory tests will show signs of
- Blood clotting tests (
PTand PTT) Comprehensive metabolic panelmay show increased levels of BUNand creatinine Complete blood count(CBC) may show increased white blood cell count and decreased red blood cell count Plateletcount is usually reduced Urinalysismay reveal blood and protein in the urine Urine proteintest can be used to show the amount of protein in the urine
Kidney biopsy Stool culturemay be positive for a certain type of E. coli bacteria or other bacteria
Treatment may involve:
Medications such as corticosteroids
Transfusions of packed red blood cells and platelets
Some people may have the liquid portion of their blood (plasma) removed and replaced with fresh (donated) plasma, or the plasma is filtered to remove
This is a serious illness in both children and adults, and it can cause death. With proper treatment, more than half of patients will recover. The outcome is better in children than adults.
- Blood clotting problems
- Kidney failure
- Nervous system problems
- Too few platelets (
Calling your health care provider
Call your health care provider if you develop symptoms of HUS. Emergency symptoms include:
Blood in the stool
Reduced alertness (consciousness)
Call your health care provider if you have had an episode of HUS and your urine output decreases, or you develop other new symptoms.
You can prevent the known cause, E. coli, by cooking hamburger and meats well and avoiding contact with unclean water.