Hemolytic-uremic syndrome (HUS)

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Male urinary system

HUS

Early symptoms:

• Fever
• Vomiting and diarrhea
• Blood in the stools
• Irritability
• Weakness
• Lethargy

• Low urine output
• No urine output
• Paleness
• Bruising
• Skin rash that looks like fine red spots (petechiae)
• Yellowish coloration to the skin (jaundice)
• Decreased consciousness
• Seizures -- rare

A physical examination may show an enlarged liver or spleen. There may be variable, abnormal nervous system changes. There is laboratory evidence of hemolytic anemia and acute renal failure.

• A complete blood count (CBC ) might show:
  • Decreased platelet count (thrombocytopenia)
  • Rupture of red blood cells
  • Anemia from loss of red blood cells (hemolytic anemia)
  • Elevated white blood count
• Coagulation studies such as PT and PTT may be normal or abnormal.
• Blood chemistry such as a chem-20 shows abnormalities, such as:
  • BUN is elevated
  • Creatinine is elevated
  • Free hemoglobin is elevated
• A urinalysis demonstrates:
  • Blood in the urine
  • Protein in the urine
• A urine protein test can be used to show the amount of protein in the urine.

• Stool culture may be positive for a specific type of E. coli .
• Kidney biopsy shows diagnostic changes.

Review Date: 06/08/2005
Reviewed By: Samer Shihabi, M.D., Sacramento Center for Hematology and Medical Oncology, Sacramento, CA. Review provided by VeriMed Healthcare Network.