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Hemolytic Uremic Syndrome, Pediatric

Erica Winnicki, MD and Marsha May Lee, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Hemolytic uremic syndrome (HUS) is characterized by the triad of acute kidney injury, thrombocytopenia, and hemolytic anemia with fragmentation of erythrocytes (schistocytes noted on...

DIAGNOSIS

HISTORY

  • GI prodrome: STEC-HUS typically develops 5 to 13 days after the onset of diarrhea (usually bloody). There can be associated vomiting and fever.

  • Symptoms of pneumonia or meningitis: S. ...

TREATMENT

GENERAL MEASURES

  • Treatment of STEC-HUS is generally supportive. The mainstay of therapy involves the following:

    • Strict fluid balance

    • Nutritional support

    • Control of hypertension

    • Treatment of seizu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Resolution is usually heralded by a rise in platelet count and a gradual decrease in the frequency of blood transfusions.

  • Pancreatic insufficiency may persist, req...

ADDITIONAL READING

  • Joseph C, Gattineni J. Complement disorders and hemolytic uremic syndrome. Curr Opin Pediatr.  2013;25(2):209–215. [View Abstract on OvidInsights]

  • Loirat C, Fakhouri F, Ariceta ...

CODES

ICD9

283.11 Hemolytic-uremic syndrome 

ICD10

D59.3 Hemolytic-uremic syndrome 

SNOMED

  • 111407006 Hemolytic uremic syndrome (disorder)

  • 36568005 Hemolytic uremic syndrome of childhood

FAQ

  • Q: What factors should raise concern for aHUS?

  • A: Age <6 months at presentation, insidious onset, relapsing disease, or failure to identify STEC or Stx in the stool

  • Q: How many patients with gast...

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