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  4. Hemolytic Uremic Syndrome (HUS)

Hemolytic Uremic Syndrome (HUS)

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What is Hemolytic Uremic Syndrome?   

Hemolytic uremic syndrome (HUS) is a condition that affects the blood and blood vessels. It results in the destruction of blood platelets (cells involved in clotting), a low red blood cell count (anemia) and kidney failure due to damage to the very small blood vessels of the kidneys. Other organs, such as the brain or heart, may also be affected by damage to very small blood vessels.

HUS usually develops in children after five to 10 days of diarrhea — often bloody — caused by infection with certain strains of Escherichia coli (E. coli) bacteria. Adults also can develop HUS due to E. coli or other types of infection, certain medications, or pregnancy.

HUS is a serious condition. But timely and appropriate treatment leads to a full recovery for most people, especially young children.

What are the causes of HUS?   

The most common cause of HUS — particularly in children under the age of 5 — is infection with E. coli bacteria that produce certain toxins (shiga toxin-producing E. coli or STEC). 

E. coli can be found in:

  • Contaminated meat or produce
  • Swimming pools or lakes contaminated with feces

Other causes can include:

  • The use of certain medications, such as quinine sulfate (Qualaquin), some chemotherapy medications, medications containing the immunosuppressant cyclosporine (Neoral, Sandimmune, Gengraf) and anti-platelet medications.
  • HIV/AIDS, pneumococcal infection.
  • Sometimes, pregnancy

What are the signs and symptoms of HUS?

It can include: 

  • Bloody diarrhea
  • Decreased urination or blood in the urine
  • Abdominal pain, vomiting and occasionally fever
  • Pallor
  • Small, unexplained bruises or bleeding from the nose and mouth
  • Fatigue and irritability
  • Confusion or seizures
  • High blood pressure
  • Swelling of the face, hands, feet or entire body

How does HUS effect the kidneys?   

In HUS the tiny filter units in the kidneys known as glomeruli become clogged with platelets and damaged red blood cells. This leads to problems with the kidney's ability to filter and eliminate waste products.

When to see a doctor?  

See your doctor immediately if you or your child experiences bloody diarrhea or several days of diarrhea followed by:

  • Decreased urine output
  • Unexplained bruises
  • Unusual bleeding
  • Extreme fatigue

Seek emergency care if you or your child doesn't urinate for 12 hours or more.

What are complications of HUS?

  • Kidney failure, which can be sudden (acute) or develop over time (chronic)
  • High blood pressure
  • Stroke
  • Coma
  • Intestinal problems, such as inflammatory colitis
  • Heart problems

What happens if kidney failure occurs?   

When HUS causes mild kidney failure, close attention to the patient, especially to fluid volume, may be all that is necessary for adequate treatment. When it causes severe kidney failure (when kidney function is less than 10 percent of normal), dialysis may be needed to do the work of the kidneys. Different forms of dialysis may be used depending on each individual's needs. Most HUS patients that require dialysis ultimately recover their kidney function.

How to Diagnose HUS?   

To confirm a diagnosis of HUS, your doctor is likely to recommend lab tests, including Blood tests, urine analysis and a stool analysis (to detect toxin producing E-coli and other bacteria that can cause HUS).

HUS Treatment entails:   

  • Fluid replacement. Lost fluid and electrolytes must be carefully replaced because the kidneys aren't removing fluids and waste as efficiently as normal.
  • Red blood cell transfusions. Red blood cells, transfused through an intravenous (IV) needle, can help reverse signs and symptoms of HUS including chills, fatigue, shortness of breath, rapid heart rate, yellow skin and dark urine.
  • Platelet transfusions. IV transfusions of platelets can help your blood clot more normally if you're bleeding or bruising easily.
  • Plasma exchange. Plasma is the part of blood that supports the circulation of blood cells and platelets. Sometimes a machine is used to clear the blood of its own plasma and replace it with fresh or frozen donor plasma.
  • Kidney dialysis. Sometimes dialysis is needed to filter waste and excess fluid from the blood. Dialysis is usually a temporary treatment until the kidneys begin functioning adequately again. But if you have significant kidney damage, you might need long-term dialysis.


Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes. 

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