Hemolytic Uremic Syndrome Explained in Simple Terms
by Beth G. Hodges, MD

Hemolytic uremic syndrome is a disease of abnormal clotting of blood in the capillaries that damages red blood cells as they pass by (hemolysis) and subsequently causes kidney failure (uremia.) It can occur at different ages, but 90% of the cases that occur in children happen after exposure to E. Coli food poisoning, specifically, type OH157:H7.

Pregnancy and use of oral contraceptive pills have been associated with occurrences in adult women. There has also been an association with pneumonia due to streptococcal pneumoniae bacteria, the AIDS virus, chemotherapy for cancer, medications (Ticlid and quinine), and also, rarely, an inherited type of hemolytic uremic syndrome (HUS.)

Prominent symptoms of hemolytic uremic syndrome include anemia, low platelet count, fatigue, purpura ( a distinctive skin rash seen on the buttocks and thighs due to bleeding into the skin), kidney failure, and blood and protein present in the urine.

Children, though they require supportive care during the acute illness, tend to do better with hemolytic uremic syndrome and almost always make a full recovery.

Adults struck by hemolytic uremic syndrome will usually require plasmapheresis (plasma exchange) and may require dialysis due to more severe kidney failure. Without aggressive care, 40% of adults with hemolytic uremic syndrome may die and 80% will be left with permanent kidney damage. With aggressive treatment, 10% will still die but only 25% will have permanent kidney damage.

Other than with the inherited form of the disorder, it is very difficult to tell who may be at risk. The best way to prevent the disorder is to fully cook food and avoid consuming anything potentially contaminated, especially undercooked hamburger meat, a common source of E.Coli infections.

Published - December, 2009