Hemolytic-uremic syndrome history and symptoms: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
m (Categories)
No edit summary
 
(28 intermediate revisions by 5 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{HUS}}
{{HUS}}
{{CMG}}
{{CMG}} {{shyam}}; {{AE}} {{S.G.}}, {{AHS}}


==Overview==
==Overview==
The majority of patients with [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] ([[Hemolytic-uremic syndrome|HUS]]) are [[asymptomatic]]. It usually start with [[gastrointestinal]] [[prodrome]] including [[bloody diarrhea]] and [[fever]] that may occur 2-7 days before the onset of [[renal failure]]. Other [[Symptom|symptoms]] include [[nausea]], [[vomiting]], [[abdominal pain]] and [[swelling]], decreased [[urination]], [[fatigue]], [[irritability]], and [[swelling]] of body.


==History and Symptoms==
==History and Symptoms==
The classic childhood case of HUS occurs after bloody [[diarrhea]] caused by [[Escherichia coli O157:H7|''E. coli'' O157:H7]], a strain of ''[[E. coli]]'' that expresses [[verotoxin]] (also called [[Shiga toxin]]). The toxin enters the bloodstream, attaches to [[kidney|renal]] [[endothelium]] and initiates an [[inflammation|inflammatory]] reaction leading to [[acute renal failure]] (ARF) and [[disseminated intravascular coagulation]] (DIC). The [[fibrin]] mesh destroys [[red blood cell]]s and captures [[thrombocytes]], leading to a decrease of both on [[complete blood count]].  The usual age of onset is between 2 and adolescence.
*The [[hallmark]] of [[Hemolytic-uremic syndrome|HUS]] is [[Diarrhea with blood|bloody diarrhea]] [[Dysentery|(dysentery)]].<ref>{{Cite journal
| author = [[R. Bhimma]], [[N. C. Rollins]], [[H. M. Coovadia]] & [[M. Adhikari]]
| title = Post-dysenteric hemolytic uremic syndrome in children during an epidemic of Shigella dysentery in Kwazulu/Natal
| journal = [[Pediatric nephrology (Berlin, Germany)]]
| volume = 11
| issue = 5
| pages = 560–564
| year = 1997
| month = October
| pmid = 9323280
}}</ref>
*A positive history of [[Diarrhea with blood|bloody diarrhea]] and [[Abdomen|abdominal]] [[tenderness]] is suggestive of [[HUS]]. The most common [[Symptom|symptoms]] of [[HUS]] include [[Diarrhea with blood|bloody diarrhea]] , [[fever]] and [[gastrointestinal]] complaints. The classic triad of signs/symptoms involves microangiopathic hemolytic anemia, renal failure, and thrombocytopenia.
===Common Symptoms===
Symptoms of [[HUS]] include:<ref name=":0">{{Cite journal
| author = [[T. G. Boyce]], [[D. L. Swerdlow]] & [[P. M. Griffin]]
| title = Escherichia coli O157:H7 and the hemolytic-uremic syndrome
| journal = [[The New England journal of medicine]]
| volume = 333
| issue = 6
| pages = 364–368
| year = 1995
| month = August
| doi = 10.1056/NEJM199508103330608
| pmid = 7609755
}}</ref><ref name="pmid9092315">{{cite journal |vauthors=Slutsker L, Ries AA, Greene KD, Wells JG, Hutwagner L, Griffin PM |title=Escherichia coli O157:H7 diarrhea in the United States: clinical and epidemiologic features |journal=Ann. Intern. Med. |volume=126 |issue=7 |pages=505–13 |date=April 1997 |pmid=9092315 |doi= |url=}}</ref><ref>{{Cite journal
| author = [[Phillip I. Tarr]], [[Carrie A. Gordon]] & [[Wayne L. Chandler]]
| title = Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome
| journal = [[Lancet (London, England)]]
| volume = 365
| issue = 9464
| pages = 1073–1086
| year = 2005
| month = March
| doi = 10.1016/S0140-6736(05)71144-2
| pmid = 15781103
}}</ref><ref>{{Cite journal
| author = [[Phillip I. Tarr]], [[Carrie A. Gordon]] & [[Wayne L. Chandler]]
| title = Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome
| journal = [[Lancet (London, England)]]
| volume = 365
| issue = 9464
| pages = 1073–1086
| year = 2005
| month = March
| doi = 10.1016/S0140-6736(05)71144-2
| pmid = 15781103
}}</ref><ref>{{Cite journal
| author = [[James B. Kaper]] & [[Alison D. O'Brien]]
| title = Overview and Historical Perspectives
| journal = [[Microbiology spectrum]]
| volume = 2
| issue = 6
| year = 2014
| month = December
| doi = 10.1128/microbiolspec.EHEC-0028-2014
| pmid = 25590020
}}</ref>
*<nowiki/><nowiki/><nowiki/>[[Diarrhea with blood|Bloody diarrhe]]<nowiki/>[[Diarrhea with blood|a]]
*<nowiki/>[[Abdominal pain]]
*Decreased [[urination]] or [[blood]] in [[urine]]
*[[Vomiting]]
*[[Fatigue]]
*[[Irritability]]
*[[Abdominal]] [[swelling]]
*<nowiki/>[[Blood in the urine]] ([[hematuria]])


HUS occurs after 2-7% of all ''E. coli'' O157:H7 infections.
===Less Common Symptoms===
 
Less common [[symptoms]] of [[Hemolytic-uremic syndrome|HUS]] include:
Adult HUS has similar symptoms and pathology but is an uncommon outcome of the following: [[HIV]]; antiphospholipid syndrome (associated with [[Lupus erythematosus]] and generalized hypercoagulability); post partum renal failure; [[malignant hypertension]]; [[scleroderma]]; and cancer [[chemotherapy]] (mitomycin, cyclosporine, cisplatin and bleomycin).
*[[Swollen face]]
 
*[[Swollen face|Swollen]] [[Swollen limbs|limbs]]
A third category is referred to as familial HUS. It represents 5-10% of HUS cases and is largely due to mutations in the complement proteins [[factor H]], [[membrane cofactor protein]] and [[factor I]] leading to uncontrolled [[complement system]] activation. Recurrent thromboses result in a high mortality rate.
*[[Seizure|Seizures]]
 
*HUS often begins with [[vomiting]] and [[diarrhea]], which may be bloody. Within a week, the person may become weak and irritable. Persons with this condition may urinate less than normal. Urine output may almost stop.
 
*Red blood cell destruction leads to symptoms of [[Anemia (patient information)|anemia]].
 
*'''Early symptoms:'''
:*Blood in the stools
:*Irritability
:*[[Fever]]
:*Lethargy
:*[[Vomiting]] and [[diarrhea]]
:*Weakness
 
*'''Later symptoms:'''
:*Bruising
:*Decreased consciousness
:*Low urine output
:*No urine output
:*Pallor
:*Seizures -- rare
:*Skin rash that looks like fine red spots ([[petechiae]])
:*Yellow skin ([[jaundice]])


==References==
==References==
{{reflist|2}}
{{Reflist|2}}


{{WH}}
{{WH}}

Latest revision as of 00:33, 21 December 2018

Hemolytic-uremic syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hemolytic-uremic syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hemolytic-uremic syndrome history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hemolytic-uremic syndrome history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hemolytic-uremic syndrome history and symptoms

CDC on Hemolytic-uremic syndrome history and symptoms

Hemolytic-uremic syndrome history and symptoms in the news

Blogs on Hemolytic-uremic syndrome history and symptoms

Directions to Hospitals Treating Hemolytic-uremic syndrome

Risk calculators and risk factors for Hemolytic-uremic syndrome history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [3], Anila Hussain, MD [4]

Overview

The majority of patients with hemolytic uremic syndrome (HUS) are asymptomatic. It usually start with gastrointestinal prodrome including bloody diarrhea and fever that may occur 2-7 days before the onset of renal failure. Other symptoms include nausea, vomiting, abdominal pain and swelling, decreased urination, fatigue, irritability, and swelling of body.

History and Symptoms

Common Symptoms

Symptoms of HUS include:[2][3][4][5][6]

Less Common Symptoms

Less common symptoms of HUS include:

References

  1. ↑ R. Bhimma, N. C. Rollins, H. M. Coovadia & M. Adhikari (1997). "Post-dysenteric hemolytic uremic syndrome in children during an epidemic of Shigella dysentery in Kwazulu/Natal". Pediatric nephrology (Berlin, Germany). 11 (5): 560–564. PMID 9323280. Unknown parameter |month= ignored (help)
  2. ↑ T. G. Boyce, D. L. Swerdlow & P. M. Griffin (1995). "Escherichia coli O157:H7 and the hemolytic-uremic syndrome". The New England journal of medicine. 333 (6): 364–368. doi:10.1056/NEJM199508103330608. PMID 7609755. Unknown parameter |month= ignored (help)
  3. ↑ Slutsker L, Ries AA, Greene KD, Wells JG, Hutwagner L, Griffin PM (April 1997). "Escherichia coli O157:H7 diarrhea in the United States: clinical and epidemiologic features". Ann. Intern. Med. 126 (7): 505–13. PMID 9092315.
  4. ↑ Phillip I. Tarr, Carrie A. Gordon & Wayne L. Chandler (2005). "Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome". Lancet (London, England). 365 (9464): 1073–1086. doi:10.1016/S0140-6736(05)71144-2. PMID 15781103. Unknown parameter |month= ignored (help)
  5. ↑ Phillip I. Tarr, Carrie A. Gordon & Wayne L. Chandler (2005). "Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome". Lancet (London, England). 365 (9464): 1073–1086. doi:10.1016/S0140-6736(05)71144-2. PMID 15781103. Unknown parameter |month= ignored (help)
  6. ↑ James B. Kaper & Alison D. O'Brien (2014). "Overview and Historical Perspectives". Microbiology spectrum. 2 (6). doi:10.1128/microbiolspec.EHEC-0028-2014. PMID 25590020. Unknown parameter |month= ignored (help)

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Hemolytic-uremic_syndrome_history_and_symptoms&oldid=1511275"