Hemolytic-uremic syndrome natural history, complications and prognosis

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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 like 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, stroke, coma, 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, coma, occur in approximately 10-50%.
  • death

References

  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)
  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.
  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.
  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)
  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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