The hemolytic uremic syndrome
Some bacterial infections can cause serious kidney problems. These complaints are also called the hemolytic uremic syndrome (HUS). What exactly is HUS and is treatment possible?
Some bacterial infections are associated with the hemolytic uremic syndrome, or HUS. This is a basically rare condition characterized by the combination of kidney failure, anemia from the excessive breakdown of red blood cells (hemolytic anemia) and damage to the inner lining of the blood vessels.
Anemia
With HUS there is a clot formation, which can clog the blood vessels of various organs. This causes a decrease in blood flow to these organs, usually the brain and kidneys, affecting their function. The red blood cells that end up in partially blocked vessels are broken down and anemia develops as a result. The platelets, which play an important role in blood clotting, also clump together, resulting in a shortage of platelets circulating freely in the blood.
intestinal infection
HUS generally occurs in children with intestinal infections. However, the condition is also increasingly common in adults. At a EHEC contamination the risk of HUS is quite high: 5 to 15 percent of patients with a bloody colon infection due to an intestinal infection develop HUS.
Cause
The most common cause of HUS in children is an infection of the digestive tract due to the bacteria Escherichia coli (E.coli). Other bacteria such as Shigella and Salmonella which can also cause infections of the digestive tract, sometimes also lead to their onset. In some cases, it is caused by a respiratory infection in children with bacteria such as Streptococcus and Clostridium.
Medicines
Certain viruses, tumors, and conditions such as AIDS can also cause the condition. The use of certain medicines to treat tumors of various organs also leads to HUS in rare cases.
Symptoms
Patients with haemolytic uremic syndrome usually develop a fever, vomit, and diarrhea. Sometimes blood is present in the stool. Some patients complain of general weakness and lethargy and are irritable. Other symptoms may include:
– Decreased urine production
– Skin rash
– Jaundice (yellowish discoloration of the skin)
– Small skin spots (petechiae)
– Patchy skin discolorations (purpura)
– Swollen spleen
– Swollen liver
– Bleeding in the whites of the eyes
– High bloodpressure
Diagnosis
The diagnosis of HUS is made on the basis of the symptoms, a physical examination and further diagnostic examination. Urinalysis often reveals blood and abnormal proteins. Sometimes a bone marrow examination is done.
Therapy
Since there is no specific treatment for the disease, patients with hemolytic uremic syndrome receive supportive treatment based on symptoms. Supportive treatments usually include:
– Blood transfusions
– Drug treatment
– Trying to maintain fluid and salt balance
– Kidney dialysis
Complications
HUS patients – especially children – usually recover within a short time, without residual damage. However, HUS can result in severe renal failure. Adults with HUS often remain dependent on kidney dialysis and sometimes kidney transplantation. Death by HUS also occurs.
