Hemolytic-uremic syndrome natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
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 | 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]]. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===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 , | *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 | ||
| author = [[Nur Canpolat]] | | author = [[Nur Canpolat]] | ||
| title = Hemolytic uremic syndrome | | title = Hemolytic uremic syndrome | ||
| Line 21: | Line 21: | ||
| pmid = 26265890 | | pmid = 26265890 | ||
}}</ref> | }}</ref> | ||
*The symptoms of HUS typically develop 5–15% of the cases. <ref>{{Cite journal | *The [[Symptom|symptoms]] of [[Hemolytic-uremic syndrome|HUS]] typically develop 5–15% of the cases. <ref>{{Cite journal | ||
| author = [[Nur Canpolat]] | | author = [[Nur Canpolat]] | ||
| title = Hemolytic uremic syndrome | | title = Hemolytic uremic syndrome | ||
| Line 33: | Line 33: | ||
| pmid = 26265890 | | pmid = 26265890 | ||
}}</ref> | }}</ref> | ||
*If left untreated 15% of patients with HUS may progress to develop rectal prolapse, 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> | *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=== | ===Complications=== | ||
Common complications of HUS include:<ref name="KarpmanLoos2017" /><ref name="MeleRemuzzi2014" /><ref name=":0" /><ref name=":1" /> | 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 | * Approximately 15% of pations of [[EHEC]]‐associated [[gastroenteritis]] will develop [[Hemolytic-uremic syndrome|HUS]]. | ||
* The most common cause of acute kidney injury (AKI) in childern . | * The most common cause of [[acute kidney injury]] ([[AKI]]) in childern . | ||
* Hypertension (HTN) | * [[Hypertension]] ([[HTN]]) | ||
* | * [[End-stage renal disease]] | ||
* 9% renal transplants in children and adolescents. | * 9% [[Transplant of kidney|renal transplants]] in children and [[Adolescent|adolescents]]. | ||
* Neurological complications: hemiparesis, seizure, coma | * [[Neurological]] [[Complication (medicine)|complications]]: [[hemiparesis]], [[seizure]], [[coma]] and [[stroke]] occur in approximately 10-50%. | ||
* death | * death | ||
===Prognosis=== | ===Prognosis=== | ||
Common complications of 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 | 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 | ||
| author = [[Takashi Hosaka]], [[Kiyotaka Nakamagoe]] & [[Akira Tamaoka]] | | author = [[Takashi Hosaka]], [[Kiyotaka Nakamagoe]] & [[Akira Tamaoka]] | ||
| title = Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids | | title = Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids | ||
| Line 80: | Line 80: | ||
| pmid = 23202315 | | pmid = 23202315 | ||
}}</ref> | }}</ref> | ||
*Approximately 15% of patients of | *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 HUS progress to end stage renal failure within 4 years and about 25% have long term renal impairment | * 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% renal transplants in children and adolescents. | * 9% [[Transplant of kidney|renal transplants]] in children and adolescents. | ||
* Neurological complications: | * [[Neurological]] [[Complication (medicine)|complications]]: [[hemiparesis]], [[seizure]], [[coma]], [[stroke]], occur in approximately 10-50%. | ||
* death | * death | ||
Revision as of 15:18, 21 August 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2]
Overview
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]
- Approximately 15% of pations of EHEC‐associated gastroenteritis will develop HUS.
- The most common cause of acute kidney injury (AKI) in childern .
- Hypertension (HTN)
- End-stage renal disease
- 9% renal transplants in children and adolescents.
- Neurological complications: hemiparesis, seizure, coma and stroke occur in approximately 10-50%.
- 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.
- Neurological complications: hemiparesis, seizure, coma, stroke, occur in approximately 10-50%.
- death
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)