Hemolytic uremic syndrome

Revisión del 06:21 25 jun 2011 de Jswartz (discusión | contribs.) (Created page with "==Background== *Triad of: **Acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia *Most common cause of ARF in children **Most common in children <10yr (2/3 of...")
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Background

  • Triad of:
    • Acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia
  • Most common cause of ARF in children
    • Most common in children <10yr (2/3 of cases in <5yr)
  • Most common cause is E. coli O157:H7 infection

Diagnosis

Presentation

  • E. coli enteritis
    • N/V, bloody diarrhea
    • Within a week develops pallor, oliguria, lethargy, sz, encephalopathy

Work-Up

  • CBC
    • WBC may be elevated
    • Anemia
      • Schistocytes, helmet/burr cells
    • Thrombocytopenia
  • Stool tests
    • Shiga toxin, E. coli O157:H7 test
  • UA
    • Hematuria, casts
  • Bilirubin (hemolysis)
  • Chemistry
    • Hyperkalemia (renal failure)

DDx

  • Acute gastroenteritis
  • Appendicitis
  • Colitis
  • Intussusception
  • IBD
  • Perforation
  • DIC
  • TTP
  • SLE

Treatment

  • Supportive
    • Fluid for hypovolemia, transfusion for anemia
  • Antibiotics are not indicated
  • Platelets are contraindicated
  • Emergency dialysis if indicated

Disposition

Admit all

Source

Tintinalli

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