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| ==History and Symptoms== | | ==History and Symptoms== |
| The classic childhood case of HUS occurs after bloody [[diarrhea]] caused by [[Escherichia coli O157:H7|''E. coli'' O157:H7]], a strain of ''[[E. coli]]'' that expresses [[verotoxin]] (also called [[Shiga toxin]]). The toxin enters the bloodstream, attaches to [[kidney|renal]] [[endothelium]] and initiates an [[inflammation|inflammatory]] reaction leading to [[acute renal failure]] (ARF) and [[disseminated intravascular coagulation]] (DIC). The [[fibrin]] mesh destroys [[red blood cell]]s and captures [[thrombocytes]], leading to a decrease of both on [[complete blood count]]. The usual age of onset is between 2 and adolescence.
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| HUS occurs after 2-7% of all ''E. coli'' O157:H7 infections.
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| Adult HUS has similar symptoms and pathology but is an uncommon outcome of the following: [[HIV]]; antiphospholipid syndrome (associated with [[Lupus erythematosus]] and generalized hypercoagulability); post partum renal failure; [[malignant hypertension]]; [[scleroderma]]; and cancer [[chemotherapy]] (mitomycin, cyclosporine, cisplatin and bleomycin).
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| A third category is referred to as familial HUS. It represents 5-10% of HUS cases and is largely due to mutations in the complement proteins [[factor H]], [[membrane cofactor protein]] and [[factor I]] leading to uncontrolled [[complement system]] activation. Recurrent thromboses result in a high mortality rate.
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| *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 less than normal. Urine output may almost stop.
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| *Red blood cell destruction leads to symptoms of [[Anemia (patient information)|anemia]].
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| *'''Early symptoms:'''
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| :*Blood in the stools
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| :*Irritability
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| :*[[Fever]]
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| :*Lethargy
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| :*[[Vomiting]] and [[diarrhea]]
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| :*Weakness
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| *'''Later symptoms:'''
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| :*Bruising
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| :*Decreased consciousness
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| :*Low urine output
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| :*No urine output
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| :*Pallor
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| :*Seizures -- rare
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| :*Skin rash that looks like fine red spots ([[petechiae]])
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| :*Yellow skin ([[jaundice]]) | |
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| ==References== | | ==References== |