Hemolytic-uremic syndrome: Difference between revisions

Revision as of 12:25, 15 August 2020

Background

Typical HUS is a Thrombotic microangiopathy with prominent renal failure traditionally associated with Shiga toxin-producing Escherichia coli infection, especially enterohemorrhagic E. coli O157:H7
Difference pathophysiology and treatment from atypical hemolytic-uremic syndrome

Pathophysiology

Typical HUS is caused by Shiga toxin from enterohemorrhagic Escherichia coli (e.g. O157:H7)
Toxin is absorbed systemically, causing platelet activation and aggregation

Risk Factors

Younger age
Exposure to antibiotics
Increased WBC count
Vomiting
Prolonged diarrhea
Presence of stx2a and eae genes

Clinical Manifestations

Abdominal pain and watery diarrhea about 4 days after exposure to toxin, progressing to bloody diarrhea with or without vomiting
- Up to one third do not have bloody diarrhea
- Fever is mild or absent
About 7 days after onset of diarrhea, HUS develops
- Progression of hemolytic anemia, thrombocytopenia, and severe AKI
Other preceding infections can include UTI, SSTI, or other causes of gastroenteritis

Management

Supportive

@@ Line 4: / Line 4: @@
 *Difference pathophysiology and treatment from [[atypical hemolytic-uremic syndrome]]
-=== Pathophysiology ===
+===Pathophysiology===
-* Typical HUS is caused by Shiga toxin from enterohemorrhagic [[Escherichia coli]] (e.g. O157:H7)
+*Typical HUS is caused by Shiga toxin from enterohemorrhagic [[Escherichia coli]] (e.g. O157:H7)
-* Toxin is absorbed systemically, causing platelet activation and aggregation
+*Toxin is absorbed systemically, causing platelet activation and aggregation
-=== Risk Factors ===
+===Risk Factors===
-* Younger age
+*Younger age
-* Exposure to antibiotics
+*Exposure to antibiotics
-* Increased WBC count
+*Increased WBC count
-* Vomiting
+*Vomiting
-* Prolonged diarrhea
+*Prolonged diarrhea
-* Presence of ''stx2a'' and ''eae'' genes
+*Presence of ''stx2a'' and ''eae'' genes
-== Clinical Manifestations ==
+==Clinical Manifestations==
+*Abdominal pain and watery diarrhea about 4 days after exposure to toxin, progressing to bloody diarrhea with or without [[vomiting]]
-* A few days of bloody diarrhea
+**Up to one third do not have bloody diarrhea
-* Progression of [[hemolytic anemia]], [[thrombocytopenia]], and severe [[AKI]]
+**Fever is mild or absent
+*About 7 days after onset of diarrhea, HUS develops
+**Progression of [[hemolytic anemia]], [[thrombocytopenia]], and severe [[AKI]]
+*Other preceding infections can include [[UTI]], [[SSTI]], or other causes of [[gastroenteritis]]
-== Management ==
+==Management==
-* Supportive
+*Supportive
 [[Category:Hematology]]