What Is Hemolytic Uremic Syndrome?
Hemolytic Uremic Syndrome is a medical condition in which there is premature destruction of RBCs in an uncontrolled way. Once started, the destructed RBCs tend to accumulate in the filtering system of kidneys eventually leading to acute renal failure which can be a potentially serious disease. Majority of cases of Hemolytic Uremic Syndrome develop in children after a week of persistent bloody diarrhea as a result of bacterial infection due to E. Coli. This condition can also develop in adults due to E. Coli infection but it may also be caused as a result of certain classes of medications, infections due to other sources etc. Even though Hemolytic Uremic Syndrome is a potentially serious condition which may cause acute renal failure but if treated appropriately and promptly then the affected individual can completely recover.
What Are The Causes Of Hemolytic Uremic Syndrome?
Hemolytic Uremic Syndrome can be caused due to numerous reasons but the most common of it, especially in children is infection caused due to E. Coli. E. coli is a type of bacteria which are normally found in the intestines of an individual. Most forms of these bacteria are not harmful but some forms of E. Coli can cause serious infections of which one form causes Hemolytic Uremic Syndrome. These forms of bacteria can be found in contaminated meat or contaminated swimming pools. It is not a thumb rule all people with this serious form of bacteria will develop Hemolytic Uremic Syndrome. This condition can also be caused due to other types of bacteria. Some of the other causes of Hemolytic Uremic Syndrome are:
- Using medications like quinine
- Certain medications used for chemotherapy
- Medications like cyclosporine
- Infections like HIV/AIDS
- In some cases this condition can also be passed down from one generation to another hence there is also a genetic link to it.
What Are Some Of The Risk Factors For Hemolytic Uremic Syndrome?
Some of the risk factors for developing Hemolytic Uremic Syndrome are:
- This disease is mostly found in children under 5 years of age
- Genetic predisposition
- Young children and the elderly population who have compromised immune system are predisposed to getting this condition.
What Are Some Of The Symptoms Of Hemolytic Uremic Syndrome?
Some of the symptoms of Hemolytic Uremic Syndrome are:
- Bloody diarrhea
- Pain in the abdomen
- Pale skin
- Severe fatigue
- Low grade fever
- Idiopathic nosebleeds
- Decreased urinary output
- Swelling of some parts of the body
- Mental confusion
- In some cases, seizures.
How Is Hemolytic Uremic Syndrome Diagnosed?
If Hemolytic Uremic Syndrome is suspected then the treating physician will perform the following diagnostic tests:
Blood Tests: Blood tests will be done to identify decreased levels of RBCs or increased creatinine indicating renal dysfunction. The blood test may also indicate presence of any damaged RBCs.
Urine Test: This test may be done to identify presence of any hematuria
Stool Analysis: This test may be done to identify presence of any bacteria causing the symptoms.
What Are Treatments For Hemolytic Uremic Syndrome?
The treatment for Hemolytic Uremic Syndrome is done in a hospital setting. Some of the treatment measures taken for treating Hemolytic Uremic Syndrome are:
Fluid Replacement: The fluids and electrolytes need to be replaced in a timely fashion as the kidneys are not able to get rid of fluids and waste products due to the condition.
Transfusion of RBCs: If during diagnostic studies it is identified that the RBCs are less making you extremely tired and dyspneic along with having tachycardia, jaundice, and dark colored urine then transfusion of RBCs may be required to treat the symptoms.
Platelet Transfusion: In cases where the patient has easy bruising or bleeding, platelet transfusions are required to help with the clotting factor. These transfusions are done intravenously.
Plasmapheresis: This is done by using a machine to clear the blood of the plasma and replacing it with fresh plasma or frozen plasma from a donor.
Dialysis: In cases of renal failure, dialysis may need to be done on a regular basis to get rid of waste products which is collected in the body due to kidney not functioning appropriately. Dialysis is usually done till the kidney starts to function normally again post treatment, although if there is significant damage to the kidneys then the patient may require permanent dialysis.
Although Hemolytic Uremic Syndrome may sound a potentially serious disease if the above treatment methods are done in a timely fashion then it often leads to complete recovery, especially children.
In people with significant kidney damage and hypertension, eating a low protein diet and taking ACE inhibitors to control hypertension can prevent further damage to the kidneys.
There is another form of Hemolytic Uremic Syndrome called the Atypical Hemolytic Uremic Syndrome which is also treated with plasmapheresis along with use of a medication called Soliris
How Can Hemolytic Uremic Syndrome Be Prevented?
There are no specific preventive measures for Hemolytic Uremic Syndrome but an individual can take measures to avoid contracting infection due to E. Coli and other infections caused by taking contaminated food. These measures are as follows:
- Washing hands properly before eating
- Keeping the utensils clean and washed
- Making sure that the food surfaces are kept absolutely clean
- Keep raw foods and prepared foods separately
- Defrost raw meat in microwave
- If eating beef then making sure that it is cooked at appropriate temperature
- Washing fruits and vegetables properly
- Avoiding unpasteurized milk
- Avoiding swimming in contaminated lakes or pools
- Making sure that everyone in the family adopt healthy cleaning habits after using the toilet like washing the hands after using the toilet, making sure to wash the hand after changing diapers of infants.
- For childcare facilities it is always advisable that soiled diapers not be put in the same room where food is prepared and cooked for children to eat.
- MedlinePlus. (2021). Hemolytic Uremic Syndrome (HUS). https://medlineplus.gov/ency/article/000510.htm
- Cleveland Clinic. (2022). Hemolytic Uremic Syndrome (HUS) in Children. https://my.clevelandclinic.org/health/diseases/21399-hemolytic-uremic-syndrome-hus-in-children
- World Journal of Nephrology. (2020). Hemolytic Uremic Syndrome: An Overview. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221885/