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Alternative Names Return to topHUS
Definition Return to top
Hemolytic-uremic syndrome (HUS) is a disorder that usually occurs when an infection in the digestive system produces toxic substances that destroy red blood cells. It often affects the kidneys.
Causes Return to top
Hemolytic-uremic syndrome (HUS) often occurs after a gastrointestinal infection with E. coli bacteria (Escherichia coli O157:H7). However, the condition has also been linked to other gastrointestinal infections, including shigella and salmonella , as well as non-gastrointestinal infections.
HUS is most common in children. It was once very rare, but it is increasing in children. It is the most common cause of acute kidney failure in children. Several large outbreaks in 1992 and 1993 were linked to undercooked hamburger meat contaminated with E. coli.
Other risk factors for HUS are unknown, although some cases are due to a familial form of the disease. HUS may occur with a variety of other diseases and infections, and after taking certain medications such as mitomycin C or ticlopidine.
HUS is more complicated in adults. It is similar to another disease called thrombotic thrombocytopenic purpura (TTP).
Symptoms Return to top
HUS often begins with vomiting and diarrhea, which may be bloody. Within a week, the person may become weak and irritable. Persons with this condition may urinate far less than normal. Urine output may almost stop.
Red blood cell destruction leads to symptoms of anemia.
Exams and Tests Return to top
The health care provider will perform a physical exam. This may show:
Laboratory tests will show signs of hemolytic anemia and acute renal failure. Laboratory tests may include:
Treatment Return to top
Treatment may involve:
Some people may have the liquid portion of their blood (plasma) removed and replaced with fresh (donated) plasma, or the plasma is filtered to remove antibodies from the blood.
Outlook (Prognosis) Return to top
This is a serious illness in both children and adults, and it can cause death. With proper treatment, more than half of patients will recover. The outcome is better in children than adults.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you develop symptoms of HUS. Emergency symptoms include:
Call your health care provider if you have had an episode of HUS and your urine output decreases, or you develop other new symptoms.
Prevention Return to top
You can prevent the known cause, E. coli, by cooking hamburger and ground meats well and avoiding contact with unclean water.
References Return to top
McMillan R. Hemorrhagic disorders: abnormalities of platelet and vascular function. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 179.Update Date: 11/10/2008 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.