haemolytic uraemic syndrome

It is the commonest cause of acute renal failure in children, It present with a triad of:
    microangiopathic haemolytic anaemia .acute renal failure . thrombocytopenia ] . there are two forms: 1-typical diarrhoea-associated(D+HUS) is secondary to gastro enteritis with enterotoxigenic E. coli O157:H7 which produce toxins called verocytotoxins or shiga toxins , HUS follows a prodrome of bloody diarrhoea and results as a consequence of damage to the lining of kidneys caused by a secreted toxins,treatment of acute diarrhoeal illness with either antibiotics or medication to reduce bowel activity is associated with an increased risk of developing HUS,with early supportive therapy ,including dialysis the typical HUS usually has a good prognosis, although follow up is necessary as there may be persistent proteinuria and developing of hypertension a declining renal function in subsequent years . 2-atypical /not diarrhoea associated(D_HUS) has no diarrhoeal prodrome , often familial and frequently relapses it has a high risk of hypertension and chronic renal failure and has a high mortality ,


  • تم تعديل 2009/03/28
    [align=center]thanx APLY

    sooooooooooooo much
  • dr.joandr.joan عضو ماسي
    تم تعديل 2009/03/29
    thanks for benefit ......... and we wait for more
  • Dr.AhmadDr.Ahmad مدير عام
    تم تعديل 2009/03/30
    شكرا دكتورة عالاضافة و الموضوع الهام جدا في طب الاطفال
  • تم تعديل 2009/03/31
    بارك الله فيكم ولا شكر على واجب ولكن للحديث بقية
    early symptoms:

    HUS often begins with fever,vomiting and diarrhoea which may be bloody ,within a week the person may become weak and irritable .
    later symptoms:

    bruising and petechiae,decreased consciousness,low or even no urine out put,paleness due to anaemia ,jaundice ,and rarely seizure.

    How is it diagnosed?

    The diagnosis is made on the basis of blood tests, including blood count, examination of the blood film and kidney function.

    Stool samples will be cultured for E.coli 0157:H7 and if positive, this strongly supports the diagnosis.

    Occasionally a kidney biopsy may be performed to examine the degree and nature of kidney damage. Sometimes it may be difficult to confidently exclude TTP because the two conditions can have identical symptoms. However, in all HUS cases studied to date vWF-cleaving protease enzyme activity was normal in contrast to those diagnosed with TTP. This should allow more accurate diagnosis in the future when the test becomes widely available.

    What treatment is available?

    Effective treatment of HUS usually requires transfer to a regional specialist centre, as about 50 per cent of patients need kidney dialysis during the acute stage of the illness.

    Supportive care, such as blood transfusions and treatment of high blood pressure, are often also required.

    Plasma exchange and infusions have been used to manage the condition but their efficacy is unproven, although they may have a role in factor H deficient-associated cases.