About hemolytic uremic syndrome (hus)

What is hemolytic uremic syndrome (hus)?

Hemolytic uremic syndrome (HUS) is a condition caused by the abnormal destruction of red blood cells. The damaged red blood cells clog the filtering system in the kidneys, which can lead to life-threatening kidney failure.

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 symptoms for hemolytic uremic syndrome (hus)?

Bruising symptom was found in the hemolytic uremic syndrome (hus) condition

Signs and symptoms of HUS 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

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 the causes for hemolytic uremic syndrome (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). One such strain of E. coli is known as E. coli O157:H7. Other strains of E. coli have also been linked to HUS.

E. coli refers to a group of bacteria normally found in the intestines of healthy humans and animals. Most of the hundreds of types of E. coli are normal and harmless. But some strains of E. coli — including those that cause HUS — are responsible for serious foodborne infections.

E. coli can be found in:

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

Sometimes, E. coli infection is spread through close contact with an infected person, such as within a family or at a day care center.

Most people who are infected with E. coli, even the more dangerous strains, don't develop HUS.

Other causes of HUS 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
  • Certain infections, such as HIV/AIDSor an infection with the pneumococcal bacteria
  • Rarely, pregnancy

Susceptibility to an uncommon type of HUS — known as atypical HUS, primary HUS or complement-mediated HUS — can be passed down genetically to children. People who have inherited the mutated gene that causes atypical HUS won't necessarily develop the condition. The mutated gene might be activated after an upper respiratory or abdominal infection.



What are the treatments for hemolytic uremic syndrome (hus)?

HUS requires treatment in the hospital. To ease signs and symptoms and to prevent further problems, treatment might include:

  • 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.

Appropriate treatment leads to a full recovery for most people with HUS, especially young children.

If you have lasting kidney damage from HUS, your doctor might recommend a medication to lower your blood pressure, to prevent or delay further kidney damage. Your doctor might also recommend follow-up visits to evaluate your kidney function every year for five years.

Atypical HUS

This uncommon type of HUS is generally treated with plasma exchange. Your doctor might also recommend a medication — eculizumab (Soliris) — that can prevent the continued destruction of healthy cells. To prevent serious infection, you or your child might have a meningococcal vaccine before receiving this medication.



What are the risk factors for hemolytic uremic syndrome (hus)?

The risk of developing HUS is highest for:

  • Children under 5 years of age
  • People over 75
  • People with certain genetic changes that make them more susceptible



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