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Hemolytic Uremic Syndrome

Medical Lecture

Hemolytic uremic syndrome affects multiple organ systems and thus may present with a wide range of manifestations. Children may present with irritability, or their parents may describe an alteration in their usual behavior. Patients young and old may appear tired or lethargic with pale skin due to anemia. Elevated indirect bilirubin can result in scleral icterus and jaundice, while petechia or evidence of bruising are sometimes present due to thrombocytopenia. However, despite low platelet counts, there usually isn’t any purpura, nor signs of active bleeding. Abdominal pain, nausea, and vomiting are common, while some gastrointestinal complications that occur with less frequency include intussusception and gangrenous bowel. Decreased urine output may be due to dehydration and vomiting, but oliguria, edema, and elevated blood pressure should further elicit suspicion of renal failure. Neurologic involvement can result in confusion, seizures, and even severe coma or stroke. Other complications include hepatitis and pancreatic insufficiency, which usually results in a transient glucose intolerance. While a variety of manifestations may be present, consideration of the underlying etiology of these manifestations can alert to you the classic triad of HUS; anemia, thrombocytopenia, and acute kidney injury.

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