Hemolytic-uremic syndrome overview: Difference between revisions

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==Causes==
==Causes==
Common causes of HUS may include:<ref>{{Cite journal
| author = [[Shannon E. Majowicz]], [[Elaine Scallan]], [[Andria Jones-Bitton]], [[Jan M. Sargeant]], [[Jackie Stapleton]], [[Frederick J. Angulo]], [[Derrick H. Yeung]] & [[Martyn D. Kirk]]
| title = Global incidence of human Shiga toxin-producing Escherichia coli infections and deaths: a systematic review and knowledge synthesis
| journal = [[Foodborne pathogens and disease]]
| volume = 11
| issue = 6
| pages = 447–455
| year = 2014
| month = June
| doi = 10.1089/fpd.2013.1704
| pmid = 24750096
}}</ref><ref>{{Cite journal
| author = [[Chantal Loirat]], [[Fadi Fakhouri]], [[Gema Ariceta]], [[Nesrin Besbas]], [[Martin Bitzan]], [[Anna Bjerre]], [[Rosanna Coppo]], [[Francesco Emma]], [[Sally Johnson]], [[Diana Karpman]], [[Daniel Landau]], [[Craig B. Langman]], [[Anne-Laure Lapeyraque]], [[Christoph Licht]], [[Carla Nester]], [[Carmine Pecoraro]], [[Magdalena Riedl]], [[Nicole C. A. J. van de Kar]], [[Johan Van de Walle]], [[Marina Vivarelli]] & [[Veronique Fremeaux-Bacchi]]
| title = An international consensus approach to the management of atypical hemolytic uremic syndrome in children
| journal = [[Pediatric nephrology (Berlin, Germany)]]
| volume = 31
| issue = 1
| pages = 15–39
| year = 2016
| month = January
| doi = 10.1007/s00467-015-3076-8
| pmid = 25859752
}}</ref><ref>{{Cite journal
| author = [[Fadi Fakhouri]], [[Julien Zuber]], [[Veronique Fremeaux-Bacchi]] & [[Chantal Loirat]]
| title = Haemolytic uraemic syndrome
| journal = [[Lancet (London, England)]]
| volume = 390
| issue = 10095
| pages = 681–696
| year = 2017
| month = August
| doi = 10.1016/S0140-6736(17)30062-4
| pmid = 28242109
}}</ref><ref name="Lopes da Silva2011">{{cite journal|last1=Lopes da Silva|first1=Rodrigo|title=Viral-associated thrombotic microangiopathies|journal=Hematology/Oncology and Stem Cell Therapy|volume=4|issue=2|year=2011|pages=51–59|issn=16583876|doi=10.5144/1658-3876.2011.51}}</ref>
*[[E. coli]] (70%)- Shiga-Toxin producing E.Coli (STEC)
**primary source of infection is usually undercooked or raw ground meat products, raw milk, or fecal contamination of vegetables
**other sources include swimming pools or lakes contaminated with feces
**usually cause self-limiting infection but can lead to HUS in some, particularly in young children and elderly
**STEC is heat sensitive and destroyed by thorough cooking and WHO recommended guidelines for safer food should be used to prevent infections with foodborne organisms like STEC.
*Other Shiga-Toxin bacteria like Shigella Dysenteriae type-1.
Less common causes include:
* Genetic [[Mutation|mutations]] of complement genes/ Complement Factor abnormalities
* Infection with Campylobacter Jejuni or Salmonella Typhi
* Pneumococcal infection (commonly pneumonia, empyema, meningitis, and less commonly pericarditis, peritonitis, otitis media and bacteremia
* Pregnancy
* [[Autoimmune]] disease for example SLE, Antiphospholipid Syndrome
* Drug associated
** Antineoplastic, immunosuppressive and anti platelet
* Organ Transplantation
* Human [[immunodeficiency]] [[viral infection]] such as [[HIV AIDS|<abbr>HIV</abbr>/<abbr>AIDS</abbr>]]


==Differentiating [Disease] from Other Diseases==
==Differentiating [Disease] from Other Diseases==

Revision as of 18:54, 9 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In medicine, hemolytic-uremic syndrome (or haemolytic-uraemic syndrome, abbreviated HUS) is a disease characterized by microangiopathic hemolytic anemia, acute renal failure and a low platelet count (thrombocytopenia). It is due to the abnormal blood clotting with in the capillaries leading to RBC shearing and destruction while passing through clogged capillaries and obstruction of kidney filtration system by damaged RBC's lead to acute kidney injury and is one of the leading causes of Acute Renal failure in children. The two main types are Typical and atypical Hemolytic uremic syndrome(HUS). Typical HUS is caused following a diarrheal infection by E.Coli OH157:H7 and is responsible for 90 percent of HUS cases in Children. Atypical HUS is not associated with gastrointestinal symptoms and also has a less favorable outcome.

Historical Perspective

Classification

HUS may be classified as Typical (Caused by Shiga-toxin producing E.coli/ Shigella Infection) or Atypical (caused by Complement factor abnormalities, Other viral or bacterial infections, HIV, Malignancy, Organ transplantation, and rarely SLE and pregnancy related).

Pathophysiology

Causes

Common causes of HUS may include:[1][2][3][4]

  • E. coli (70%)- Shiga-Toxin producing E.Coli (STEC)
    • primary source of infection is usually undercooked or raw ground meat products, raw milk, or fecal contamination of vegetables
    • other sources include swimming pools or lakes contaminated with feces
    • usually cause self-limiting infection but can lead to HUS in some, particularly in young children and elderly
    • STEC is heat sensitive and destroyed by thorough cooking and WHO recommended guidelines for safer food should be used to prevent infections with foodborne organisms like STEC.
  • Other Shiga-Toxin bacteria like Shigella Dysenteriae type-1.

Less common causes include:

  • Genetic mutations of complement genes/ Complement Factor abnormalities
  • Infection with Campylobacter Jejuni or Salmonella Typhi
  • Pneumococcal infection (commonly pneumonia, empyema, meningitis, and less commonly pericarditis, peritonitis, otitis media and bacteremia
  • Pregnancy
  • Autoimmune disease for example SLE, Antiphospholipid Syndrome
  • Drug associated
    • Antineoplastic, immunosuppressive and anti platelet
  • Organ Transplantation
  • Human immunodeficiency viral infection such as HIV/AIDS

Differentiating [Disease] from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

References

  1. Shannon E. Majowicz, Elaine Scallan, Andria Jones-Bitton, Jan M. Sargeant, Jackie Stapleton, Frederick J. Angulo, Derrick H. Yeung & Martyn D. Kirk (2014). "Global incidence of human Shiga toxin-producing Escherichia coli infections and deaths: a systematic review and knowledge synthesis". Foodborne pathogens and disease. 11 (6): 447–455. doi:10.1089/fpd.2013.1704. PMID 24750096. Unknown parameter |month= ignored (help)
  2. Chantal Loirat, Fadi Fakhouri, Gema Ariceta, Nesrin Besbas, Martin Bitzan, Anna Bjerre, Rosanna Coppo, Francesco Emma, Sally Johnson, Diana Karpman, Daniel Landau, Craig B. Langman, Anne-Laure Lapeyraque, Christoph Licht, Carla Nester, Carmine Pecoraro, Magdalena Riedl, Nicole C. A. J. van de Kar, Johan Van de Walle, Marina Vivarelli & Veronique Fremeaux-Bacchi (2016). "An international consensus approach to the management of atypical hemolytic uremic syndrome in children". Pediatric nephrology (Berlin, Germany). 31 (1): 15–39. doi:10.1007/s00467-015-3076-8. PMID 25859752. Unknown parameter |month= ignored (help)
  3. Fadi Fakhouri, Julien Zuber, Veronique Fremeaux-Bacchi & Chantal Loirat (2017). "Haemolytic uraemic syndrome". Lancet (London, England). 390 (10095): 681–696. doi:10.1016/S0140-6736(17)30062-4. PMID 28242109. Unknown parameter |month= ignored (help)
  4. Lopes da Silva, Rodrigo (2011). "Viral-associated thrombotic microangiopathies". Hematology/Oncology and Stem Cell Therapy. 4 (2): 51–59. doi:10.5144/1658-3876.2011.51. ISSN 1658-3876.

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