Hemolytic Uremic Syndrome – Diagnosis and Treatment
Hemolytic uremic syndrome is a serious blood disease that can damage small blood vessels, especially in the kidneys. It belongs to a group of disorders known as thrombotic microangiopathies, which cause blood clots and low red blood cell counts.
This condition can affect both children and adults, with some cases linked to infections and others to genetic factors. Atypical hemolytic uremic syndrome is a rare form that does not result from infections and can be more severe.
The syndrome may trigger a strong proinflammatory response, making the symptoms worse. The mortality rate can vary, but early diagnosis and supportive care help limit complications.
Diagnosis
Doctors use a mix of physical exams and lab tests to find signs of hemolytic uremic syndrome (HUS). Key tests include:
- Blood Tests: These show hemolytic anemia with broken red blood cells, low platelet counts (thrombocytopenia), and high creatinine levels from kidney injury.
- Urine Tests: Doctors check for unusual protein or blood, which can point to kidney problems.
- Stool Samples: These detect E. coli or Shiga toxin-producing E. coli (STEC), which often cause bloody diarrhea and HUS.
Other tests may help if the cause is not clear. Common symptoms like abdominal pain, decreased urine, and fatigue guide testing.
Treatment
Blood and Platelet Replacements
People with hemolytic uremic syndrome often need blood transfusions in the hospital. Doctors give red blood cell transfusions to treat anemia and increase oxygen in the body.
If someone has low platelets and is bleeding or bruising easily, a platelet transfusion helps blood clot better and lowers the risk of serious bleeding. Medical staff administer blood transfusions through a vein and monitor them closely for safety.
| Type of Transfusion | Purpose |
|---|---|
| Red Blood Cells | Treats anemia |
| Platelets | Improves clotting, prevents bleeding |
Medications
Doctors use certain medicines to help protect the kidneys and prevent further damage. Blood pressure medications become important if the kidneys are not working well, since high blood pressure can make kidney problems worse.
Special treatments such as complement inhibitors target the cause of the illness, especially in the atypical form of the syndrome.
These medications help prevent more harm to the blood vessels. Before starting this type of treatment, patients need a meningitis vaccination to stay safe from possible infections caused by weakened immunity from the drug.
Advanced Medical Treatments and Operations
Sometimes, people need extra help if their kidneys are failing or cannot clean the blood well enough:
- Kidney dialysis removes waste and fluid from the blood. Some people need dialysis only for a short time, but others may need long-term treatment if their kidneys have had a lot of damage.
- Plasma exchange uses a machine to remove plasma from the blood and replace it with new or donated plasma. This clears out harmful substances.
- In cases with severe kidney damage or end-stage renal disease, doctors may perform a kidney transplant to restore kidney function.
Medical staff often provide supportive treatments, like IV fluids and nutrition through a vein, alongside these main treatments.
Getting Ready for Your Visit
Steps to Take Before Your Appointment
Anyone who has had vomiting, fever, blood in diarrhea, or abdominal pain should keep careful notes before meeting with a healthcare provider. Write down:
- When each symptom started.
- How long symptoms have lasted.
- The time since the last urine passed.
- Any swelling noticed.
- Any seizures or changes in alertness.
- Blood pressure readings, if known.
These details help during the appointment and can guide treatment decisions.
If a child is affected, track how much they drink and how often they urinate. For adults, noticing decreased urination or body swelling can also be important to share.
Bring a list of all current medicines to the visit, including over-the-counter items. It may be helpful to keep a symptom diary. Use a table format like this to organize information:
| Date | Symptom | Severity | Notes |
|---|---|---|---|
| 05/19/2025 | Vomiting | Mild | 2 times |
| 05/20/2025 | Diarrhea w/blood | Severe | 4 times, visible blood |
| 05/21/2025 | Less urine | Moderate | Once in 8 hours |
Bring this diary to your appointment and share it with your healthcare provider.
Actions to Take While Waiting
While waiting for a medical visit, focus on replacing lost fluids and minerals if tolerated. Oral rehydration solutions can prevent dehydration.
Continue to monitor for fever, high blood pressure, and any signs of a seizure. Do not give anti-diarrhea medicines without clear advice from a doctor. Always seek urgent help if confusion, severe belly pain, or problems with alertness occur.
