Hemolytic-uremic syndrome natural history, complications and prognosis: Difference between revisions

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Latest revision as of 18:39, 22 August 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2], Anila Hussain, MD [3]

Overview

Approximately 15 percent of patients with EHEC or Shiga toxin producing E.coli infection will develop HUS presenting with blood diarrhea, nausea, vomiting, and decreased urination. Common complications of HUS include renal failure which can be acute (AKI) or develop over time (chronic renal failure), hypertension, neurological problems such as stroke, seizure, coma and eventually death. Prognosis depend on the associated complications and about 12% of patients with diarrhea-associated HUS progress to end stage renal failure within 4 years and about 25% have long term renal impairment leading to 9% renal transplants in children and adolescents.

Natural History, Complications, and Prognosis

Natural History

The symptoms of HUS usually develop after eating of contaminated food in the first diarrhea is watery and become to bloody later and start with symptoms such as abdominal pain, nausea and vomiting accompany diarrhea, fever is observed less commonly.^[1]
The symptoms of HUS typically develop 5–15% of the cases.^[2]
If left untreated 15% of patients with HUS may progress to develop rectal prolapse, acute renal failure, colonic gangrene, and mortality.^[3]

Complications

Common complications of HUS include:^[3]^[4]^[5]^[6]

Acute kidney injury (AKI) in childern (Most common)
Hypertension (HTN)
End-stage renal disease
Renal transplants in children and adolescents (Approximately 9%)
Neurological complications (10-50%)
- hemiparesis
- seizure
- coma
- stroke
Death

Prognosis

Common complications of HUS include:^[3]^[4]^[5]^[6]^[7]

Approximately 15% of patients of EHEC‐associated gastroenteritis will develop HUS although it is dependent on bacterial strain and geographic location.
About 12% of patients with diarrhea-associated HUS progress to end stage renal failure within 4 years and about 25% have long term renal impairment.
9% renal transplants in children and adolescents.
Encephalopathy occurs in patients infected with enterohemorrhagic Escherichia coli (E. coli) has a high mortality rate and patients sometimes present sequelae.

References

↑ Nur Canpolat (2015). "Hemolytic uremic syndrome". Turk pediatri arsivi. 50 (2): 73–82. doi:10.5152/tpa.2015.2297. PMID 26265890. Unknown parameter |month= ignored (help)
↑ Nur Canpolat (2015). "Hemolytic uremic syndrome". Turk pediatri arsivi. 50 (2): 73–82. doi:10.5152/tpa.2015.2297. PMID 26265890. Unknown parameter |month= ignored (help)
↑ ^3.0 ^3.1 ^3.2 Karpman, Diana; Loos, Sebastian; Tati, Ramesh; Arvidsson, Ida (2017). "Haemolytic uraemic syndrome". Journal of Internal Medicine. 281 (2): 123–148. doi:10.1111/joim.12546. ISSN 0954-6820.
↑ ^4.0 ^4.1 Mele, Caterina; Remuzzi, Giuseppe; Noris, Marina (2014). "Hemolytic uremic syndrome". Seminars in Immunopathology. 36 (4): 399–420. doi:10.1007/s00281-014-0416-x. ISSN 1863-2297.
↑ ^5.0 ^5.1 Takashi Hosaka, Kiyotaka Nakamagoe & Akira Tamaoka (2017). "Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids". Internal medicine (Tokyo, Japan). 56 (21): 2937–2941. doi:10.2169/internalmedicine.8341-16. PMID 28943538. Unknown parameter |month= ignored (help)
↑ ^6.0 ^6.1 Ichiro Kamioka, Kunihiko Yoshiya, Kenichi Satomura, Hiroshi Kaito, Teruo Fujita, Kazumoto Iijima, Koichi Nakanishi, Norishige Yoshikawa, Kandai Nozu & Masafumi Matsuo (2008). "Risk factors for developing severe clinical course in HUS patients: a national survey in Japan". Pediatrics international : official journal of the Japan Pediatric Society. 50 (4): 441–446. doi:10.1111/j.1442-200X.2008.02605.x. PMID 19143964. Unknown parameter |month= ignored (help)
↑ Chad L. Mayer, Caitlin S. Leibowitz, Shinichiro Kurosawa & Deborah J. Stearns-Kurosawa (2012). "Shiga toxins and the pathophysiology of hemolytic uremic syndrome in humans and animals". Toxins. 4 (11): 1261–1287. doi:10.3390/toxins4111261. PMID 23202315. Unknown parameter |month= ignored (help)

Template:WH Template:WS

[1] Nur Canpolat (2015). "Hemolytic uremic syndrome". Turk pediatri arsivi. 50 (2): 73–82. doi:10.5152/tpa.2015.2297. PMID 26265890. Unknown parameter |month= ignored (help)

[2] Nur Canpolat (2015). "Hemolytic uremic syndrome". Turk pediatri arsivi. 50 (2): 73–82. doi:10.5152/tpa.2015.2297. PMID 26265890. Unknown parameter |month= ignored (help)

[KarpmanLoos2017-3] 3.0 ^3.1 ^3.2 Karpman, Diana; Loos, Sebastian; Tati, Ramesh; Arvidsson, Ida (2017). "Haemolytic uraemic syndrome". Journal of Internal Medicine. 281 (2): 123–148. doi:10.1111/joim.12546. ISSN 0954-6820.

[MeleRemuzzi2014-4] 4.0 ^4.1 Mele, Caterina; Remuzzi, Giuseppe; Noris, Marina (2014). "Hemolytic uremic syndrome". Seminars in Immunopathology. 36 (4): 399–420. doi:10.1007/s00281-014-0416-x. ISSN 1863-2297.

[:0-5] 5.0 ^5.1 Takashi Hosaka, Kiyotaka Nakamagoe & Akira Tamaoka (2017). "Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids". Internal medicine (Tokyo, Japan). 56 (21): 2937–2941. doi:10.2169/internalmedicine.8341-16. PMID 28943538. Unknown parameter |month= ignored (help)

[:1-6] 6.0 ^6.1 Ichiro Kamioka, Kunihiko Yoshiya, Kenichi Satomura, Hiroshi Kaito, Teruo Fujita, Kazumoto Iijima, Koichi Nakanishi, Norishige Yoshikawa, Kandai Nozu & Masafumi Matsuo (2008). "Risk factors for developing severe clinical course in HUS patients: a national survey in Japan". Pediatrics international : official journal of the Japan Pediatric Society. 50 (4): 441–446. doi:10.1111/j.1442-200X.2008.02605.x. PMID 19143964. Unknown parameter |month= ignored (help)

[7] Chad L. Mayer, Caitlin S. Leibowitz, Shinichiro Kurosawa & Deborah J. Stearns-Kurosawa (2012). "Shiga toxins and the pathophysiology of hemolytic uremic syndrome in humans and animals". Toxins. 4 (11): 1261–1287. doi:10.3390/toxins4111261. PMID 23202315. Unknown parameter |month= ignored (help)

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{HUS}}
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}}{{S.G.}}, {{AHS}}
 ==Overview==
-If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
+Approximately 15 percent of patients with [[EHEC]] or [[Shiga toxin]] producing [[Escherichia coli infection|''E.coli'' infection]] will develop [[Hemolytic-uremic syndrome|HUS]] presenting with [[Diarrhea with blood|blood diarrhea]], [[nausea]], [[vomiting]], and decreased [[urination]]. Common [[complications]] of [[Hemolytic-uremic syndrome|HUS]] include [[renal failure]] which can be [[Acute (medicine)|acute]] ([[Acute kidney injury|AKI]]) or develop over time ([[chronic renal failure]]), [[hypertension]], [[neurological]] problems such as [[stroke]], [[seizure]], [[coma]] and eventually death. Prognosis depend on the associated [[complications]] and about 12% of patients with [[diarrhea]]-associated [[Hemolytic-uremic syndrome|HUS]] progress to end stage [[renal failure]] within 4 years and about 25% have long term [[renal impairment]] leading to 9% [[Transplant of kidney|renal transplants]] in children and [[Adolescent|adolescents]].
-OR
-Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
-OR
-Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
 ==Natural History, Complications, and Prognosis==
 ===Natural History===
-*The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
+*The [[Symptom|symptoms]] of [[Hemolytic-uremic syndrome|HUS]] usually develop after eating of contaminated food in the first [[diarrhea]] is watery and become to [[Bloody diarrhea|bloody]] later and start with [[Symptom|symptoms]] such as [[abdominal pain]], [[nausea and vomiting]] accompany [[diarrhea]], [[fever]] is observed less commonly.<ref>{{Cite journal
-*The symptoms of (disease name) typically develop ___ years after exposure to ___.
+ | author = [[Nur Canpolat]]
-*If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
+ | title = Hemolytic uremic syndrome
+ | journal = [[Turk pediatri arsivi]]
+ | volume = 50
+ | issue = 2
+ | pages = 73–82
+ | year = 2015
+ | month = June
+ | doi = 10.5152/tpa.2015.2297
+ | pmid = 26265890
+}}</ref>
+*The [[Symptom|symptoms]] of [[Hemolytic-uremic syndrome|HUS]] typically develop 5–15% of the cases.<ref>{{Cite journal
+ | author = [[Nur Canpolat]]
+ | title = Hemolytic uremic syndrome
+ | journal = [[Turk pediatri arsivi]]
+ | volume = 50
+ | issue = 2
+ | pages = 73–82
+ | year = 2015
+ | month = June
+ | doi = 10.5152/tpa.2015.2297
+ | pmid = 26265890
+}}</ref>
+*If left untreated 15% of patients with [[Hemolytic-uremic syndrome|HUS]] may progress to develop [[rectal]] [[Rectal prolapse|prolapse]], [[Acute (medicine)|acute]] [[renal failure]], colonic [[gangrene]], and [[mortality]].<ref name="KarpmanLoos2017">{{cite journal|last1=Karpman|first1=Diana|last2=Loos|first2=Sebastian|last3=Tati|first3=Ramesh|last4=Arvidsson|first4=Ida|title=Haemolytic uraemic syndrome|journal=Journal of Internal Medicine|volume=281|issue=2|year=2017|pages=123–148|issn=09546820|doi=10.1111/joim.12546}}</ref>
 ===Complications===
-*Common complications of [disease name] include:
+Common [[complications]] of [[Hemolytic-uremic syndrome|HUS]] include:<ref name="KarpmanLoos2017" /><ref name="MeleRemuzzi2014" /><ref name=":0" /><ref name=":1" />
-**Approximately 15% of pations of EHEC‐associated gastroenteritis will develop HUS.<ref name="KarpmanLoos2017">{{cite journal|last1=Karpman|first1=Diana|last2=Loos|first2=Sebastian|last3=Tati|first3=Ramesh|last4=Arvidsson|first4=Ida|title=Haemolytic uraemic syndrome|journal=Journal of Internal Medicine|volume=281|issue=2|year=2017|pages=123–148|issn=09546820|doi=10.1111/joim.12546}}</ref>
+* [[Acute kidney injury]] ([[AKI]]) in childern (Most common)
+* [[Hypertension]] ([[HTN]])
-**[Complication 2]
+* [[End-stage renal disease]]
-**[Complication 3]
+* [[Transplant of kidney|Renal transplants]] in children and [[Adolescent|adolescents]] (Approximately 9%)
+* [[Neurological]] [[Complication (medicine)|complications]] (10-50%)
+** [[hemiparesis]]
+** [[seizure]]
+** [[coma]]
+** [[stroke]]
+* Death
 ===Prognosis===
-*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
+Common [[Complication (medicine)|complications]] of [[Hemolytic-uremic syndrome|HUS]] include:<ref name="KarpmanLoos2017" /><ref name="MeleRemuzzi2014">{{cite journal|last1=Mele|first1=Caterina|last2=Remuzzi|first2=Giuseppe|last3=Noris|first3=Marina|title=Hemolytic uremic syndrome|journal=Seminars in Immunopathology|volume=36|issue=4|year=2014|pages=399–420|issn=1863-2297|doi=10.1007/s00281-014-0416-x}}</ref><ref name=":0">{{Cite journal
-*Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
+ | author = [[Takashi Hosaka]], [[Kiyotaka Nakamagoe]] & [[Akira Tamaoka]]
-*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
+ | title = Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids
-*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
+ | journal = [[Internal medicine (Tokyo, Japan)]]
-*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
+ | volume = 56
+ | issue = 21
+ | pages = 2937–2941
+ | year = 2017
+ | month = November
+ | doi = 10.2169/internalmedicine.8341-16
+ | pmid = 28943538
+}}</ref><ref name=":1">{{Cite journal
+ | author = [[Ichiro Kamioka]], [[Kunihiko Yoshiya]], [[Kenichi Satomura]], [[Hiroshi Kaito]], [[Teruo Fujita]], [[Kazumoto Iijima]], [[Koichi Nakanishi]], [[Norishige Yoshikawa]], [[Kandai Nozu]] & [[Masafumi Matsuo]]
+ | title = Risk factors for developing severe clinical course in HUS patients: a national survey in Japan
+ | journal = [[Pediatrics international : official journal of the Japan Pediatric Society]]
+ | volume = 50
+ | issue = 4
+ | pages = 441–446
+ | year = 2008
+ | month = August
+ | doi = 10.1111/j.1442-200X.2008.02605.x
+ | pmid = 19143964
+}}</ref><ref>{{Cite journal
+ | author = [[Chad L. Mayer]], [[Caitlin S. Leibowitz]], [[Shinichiro Kurosawa]] & [[Deborah J. Stearns-Kurosawa]]
+ | title = Shiga toxins and the pathophysiology of hemolytic uremic syndrome in humans and animals
+ | journal = [[Toxins]]
+ | volume = 4
+ | issue = 11
+ | pages = 1261–1287
+ | year = 2012
+ | month = November
+ | doi = 10.3390/toxins4111261
+ | pmid = 23202315
+}}</ref>
+*Approximately 15% of patients of [[EHEC]]‐associated [[gastroenteritis]] will develop [[Hemolytic-uremic syndrome|HUS]] although it is dependent on [[bacterial]] [[strain]] and geographic location.
+* About 12% of patients with [[diarrhea]]-associated [[Hemolytic-uremic syndrome|HUS]] progress to [[end stage renal failure]] within 4 years and about 25% have long term [[renal impairment]].
+* 9% [[Transplant of kidney|renal transplants]] in children and adolescents.
+* [[Encephalopathy]] occurs in patients infected with [[enterohemorrhagic]] [[Escherichia coli]] ([[E. coli]])  has a high [[mortality rate]] and patients sometimes present [[Sequela|sequelae]].
 ==References==