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==Laboratory Findings==
==Laboratory Findings==


An elevated concentration of [[White blood cells|WBC]], [[Thrombocytopenia (patient information)|thrombocytopenia]], [[normocytic anemia]] is diagnostic of [[Hemolytic-uremic syndrome|HUS]].<ref name="Kottke-Marchant2017">{{cite journal|last1=Kottke-Marchant|first1=K.|title=Diagnostic approach to microangiopathic hemolytic disorders|journal=International Journal of Laboratory Hematology|volume=39|year=2017|pages=69–75|issn=17515521|doi=10.1111/ijlh.12671}}</ref><ref>{{Cite journal
Following Lab findings are seen in HUS:
| author = [[A. H. Sutor]], [[K. B. Thomas]], [[F. H. Prufer]], [[A. Grohmann]], [[M. Brandis]] & [[L. B. Zimmerhackl]]
* '''Microangiopathic Hemolytic Anemia''' with features as follows:
| title = Function of von Willebrand factor in children with diarrhea-associated hemolytic-uremic syndrome (D+ HUS)
** Low Hemoglobin level Often < 10g/dl
| journal = [[Seminars in thrombosis and hemostasis]]
** High reticulocyte count
| volume = 27
** Increased LDH level
| issue = 3
** Low Haptoglobin level
| pages = 287–292
** Negative Coombs test
| year = 2001
** Peripheral Blood smear shows fragmented RBC's (Schistiocytes, Helmet and Burr calss)
| month = June
* '''Thrombocytopenia'''
| doi = 10.1055/s-2001-15267
** Below 150,000 although typically less than 60,000. In spite of low platelet count, active bleeding is rarely seen
| pmid = 11446662
* '''Serum Chemistry abnormalities'''
}}</ref>
** High BUN
 
** High Creatinine
[[Immunohistochemistry]] among patients with [[Hemolytic-uremic syndrome|HUS]] shows reach of [[Von Willebrand factor|VWF]].
** Electrolyte abnormalities may include Hyponatremia, Hyperkalemia, Hyperphosphatemia, Hypocalcemia and acidosis (resulting from diarrhea, dehydration and renal failure)
 
** Increased Bilirubin and aminotransferases
Laboratory findings consistent with the diagnosis of [[HUS]] include:<ref>{{Cite journal
** High uric acid levels
| author = [[J. R. Brandt]], [[L. S. Fouser]], [[S. L. Watkins]], [[I. Zelikovic]], [[P. I. Tarr]], [[V. Nazar-Stewart]] & [[E. D. Avner]]
* '''Urinalysis'''-may show any of following
| title = Escherichia coli O 157:H7-associated hemolytic-uremic syndrome after ingestion of contaminated hamburgers
** Blood / Red blood cells
| journal = [[The Journal of pediatrics]]
** Protein
| volume = 125
** Bilirubin
| issue = 4
** WBC
| pages = 519–526
** Casts
| year = 1994
* '''Stool Testing'''
| month = October
** Stool culture on Sorbitol MacConkey's agar or Detection of Shiga toxin with serological testing
| pmid = 7931869
* '''Genetic Testing'''
}}</ref>
** Done if suspicion of genetic or complement mediated HUS/ recurrent HUS. However results takes weeks-month thus have no role in acute management of disease and treatment should not be delayed while awaiting results
*[[Anemia]]
*
*[[TAR syndrome|Thrombocytopenia]]
 
Some patients with [[Hemolytic-uremic syndrome|HUS]] may have [[bone marrow]] normal to increased [[Megakaryocyte|megakaryocytes]] .


==References==
==References==

Revision as of 19:55, 9 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal for patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Laboratory Findings

Following Lab findings are seen in HUS:

  • Microangiopathic Hemolytic Anemia with features as follows:
    • Low Hemoglobin level Often < 10g/dl
    • High reticulocyte count
    • Increased LDH level
    • Low Haptoglobin level
    • Negative Coombs test
    • Peripheral Blood smear shows fragmented RBC's (Schistiocytes, Helmet and Burr calss)
  • Thrombocytopenia
    • Below 150,000 although typically less than 60,000. In spite of low platelet count, active bleeding is rarely seen
  • Serum Chemistry abnormalities
    • High BUN
    • High Creatinine
    • Electrolyte abnormalities may include Hyponatremia, Hyperkalemia, Hyperphosphatemia, Hypocalcemia and acidosis (resulting from diarrhea, dehydration and renal failure)
    • Increased Bilirubin and aminotransferases
    • High uric acid levels
  • Urinalysis-may show any of following
    • Blood / Red blood cells
    • Protein
    • Bilirubin
    • WBC
    • Casts
  • Stool Testing
    • Stool culture on Sorbitol MacConkey's agar or Detection of Shiga toxin with serological testing
  • Genetic Testing
    • Done if suspicion of genetic or complement mediated HUS/ recurrent HUS. However results takes weeks-month thus have no role in acute management of disease and treatment should not be delayed while awaiting results

References

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