A health condition in which small blood vessels become damaged and inflamed throughout the body is called Hemolytic uremic syndrome (HUS). Thus, inflammation and damage provoke clots to form in these blood vessels, which usually lead to damage to the kidneys and other body organs. HUS can cause a life-threatening condition (such as kidney failure).
While anyone can get this condition, it mostly happens in young children. The primary cause of this syndrome is several strains of Escherichia coli (E. coli) bacteria. However, there are other infections, conditions, and medicines that also could provoke HUS including autoimmune diseases, pregnancy, cancer, and others. Rarely, hemolytic uremic syndrome can happen due to genetic mutations.
This condition is quite serious but with proper treatment and early diagnosis, most patients fully recover (including young children).
Symptoms
The symptoms of HUS appear according to the cause. Check below some of them:
Furthermore, all HUS types provoke damage to the blood vessels that may lead to anemia (a disease in which red blood cells break down) or blood clots that in turn lead to kidney damage. Check below for other HUS symptoms:
- Hypertension (high blood pressure)
- Confusion
- Seizures
- Stroke
- Edema (swelling of the feet, legs, or ankles), sometimes swelling can happen in the face, hands, feet, or entire body but is less common.
- Decreased urination or bloody urine
- Abnormal bleeding (including from the nose or mouth)
- Easy bruising
- Fatigue (extreme tiredness)
- Loss of skin color
If you do not urinate for more than 12 hours or have persistent bloody diarrhea for a few days, it is advised to seek medical care right away. Commonly, bloody diarrhea is followed by the following symptoms including unusual bleeding, bruising, extreme tiredness, swelling, and urinating less.
Causes
One of the most common causes of HUS is infection with certain E.coli strains, which commonly occurs in children under 5 years old. Moreover, some E.coli strains can produce a toxin called Shiga toxin (these strains are known as Shiga toxin-producing E. coli or STEC). Although many E. coli types are harmless, some of them can lead to HUS. Check below for other hemolytic uremic syndrome causes:
- Medications – Some drugs can provoke this syndrome. For example, medicines used to treat cancer (such as chemotherapy), drugs used to prevent rejection of an organ transplant, and others.
- Other infections – For example infection caused by pneumococcal bacteria, flu viruses, or human immunodeficiency virus (HIV).
- Complications of certain diseases – In rare cases, some people may experience HUS as a complication of cancer or an autoimmune disease.
Some people experience an uncommon type of HUS (also called atypical) that usually runs in families. However, not everyone who inherits this abnormal gene will get HUS. In addition, people who inherit this gene and experience certain health conditions or medicines have an increased risk of getting HUS.
Risk Factors
Commonly people get E. coli in the following cases. Examples include:
- Eat unpasteurized foods (including meat, fruits, or vegetables) or drinks
- Swim in pools or lakes that contain feces with bacteria
- People who are exposed to close contact with an infected person
Check below also who is at increased risk of getting E. coli:
- Children under 5 years old
- Those who have a weakened immune system
- People who inherit certain genes that can provoke HUS
Complications
People with hemolytic uremic syndrome can experience life-threatening complications. These include:
- Coma
- Stroke
- Seizures
- Hypertension (high blood pressure)
- Kidney failure that can occur suddenly (acute) or over time (chronic)
- Blood clots
- Heart conditions
- Digestive tract issues (including problems with pancreas, gallbladder, or intestines)
Is it Possible to Prevent Hemolytic Uremic Syndrome?
Foods and other products that may contain this bacteria usually do not smell, look, or feel bad. Check below some tips that can protect you from getting E. coli from foods:
- It is not advised to drink beverages (including milk, juice, or cider) that is not pasteurized
- Regularly wash your hands, especially before eating or preparing food
- You should also clean utensils and food surfaces
- Prepare meat to a temperature of at least 160 F degrees (71 C degrees)
- It is also recommended to defrost meat in the refrigerator or microwave not on the counter
- Always keep raw products separate from other foods and do not put cooked meat on the raw one
- You should not swim in unclean areas, especially if you have diarrhea
Diagnosis
Healthcare providers usually diagnose this condition by performing a physical examination and laboratory tests. For example:
- Blood tests – Doctors often perform these tests to determine damaged red blood cells. However, blood tests also can show a low platelet count, low red blood cell count, or elevated waste products in the blood (known as Creatinine).
- Urine tests – This test is usually done by doctors to see whether you have an infection or not. It can also determine abnormal protein and blood levels.
- Stool sample – It is used to determine whether you have E. coli in the stool.
Treatment
Commonly, HUS is treated in a hospital because it involves the replacement of lost fluids and minerals to compensate the kidneys that do work properly. Some people may also require nutrition through a vein (intravenously or IV).
Transfusions
The patients usually receive in the hospital red blood cells or platelets intravenously (transfusion). Red blood cells are required to prevent or reverse anemia symptoms and platelets help blood clot better if you experience bleeding or easy bruising.
Medications
People who experience long-lasting damage to the kidneys from HUS, require hypotension medicines to prevent or slow down kidney damage.
Additionally, doctors may also prescribe a medicine called Eculizumab for people with an atypical type of HUS to prevent more blood vessel damage. However, everyone who administers the medication listed above should get a special vaccine that helps to prevent meningitis because it is a possible adverse reaction that may occur while using this medicine.
Other Procedures
Check below some treatment options usually recommended by doctors when complications of HUS occur:
- Kidney transplant – This procedure is usually done when severe kidney damage occurs.
- Plasma exchange – The fluid part of the blood is called plasma. It helps blood cells and platelets move. Some people require an exchange of the plasma with a fresh or frozen donor one.
- Kidney dialysis – This is a procedure that helps remove waste products and extra fluid from the blood. Some people need kidney dialysis until the kidneys begin to work properly again. Unfortunately, significant kidney damage requires long-term dialysis.
Frequently Asked Questions
What is the main cause of hemolytic uremic syndrome?
Most people experience HUS due to E. coli bacteria. People commonly get this bacteria from contaminated food and drinks.
What are the primary symptoms of HUS?
These include:
- Fever
- Stomach pain
- Chills
- Headaches
- Diarrhea with blood
- Vomiting
When the infection progresses you may experience extreme tiredness, weakness, bruising, and paleness.
What are the potential complications of HUS?
- Coma
- Stroke
- Seizures
- Kidney disease
- Blood clots
- High blood pressure
In addition, sometimes HUS can provoke heart and brain problems. In case you have any other questions, ask your healthcare provider.
