Hemolytic Uremic Syndrome

November 12, 2012

Hemolytic Uremic Syndrome

Hemolytic uremic syndrome can cause short term kidney failure and usually develops following an e.coli infection.

The onset of sudden, short term kidney failure in children is most often caused by hemolytic uremic syndrome. This condition can cause serious, even life threatening, complications in some children; however most children with the condition make a full recovery with no permanent damage. Hemolytic uremic causes the destruction of healthy red blood cells, causing them to become distorted, these distorted blood cells then cause blockages in the tiny blood vessels of the kidney.

Causes

Hemolytic uremic generally develops after a bout of gastroenteritis caused by the E. Coli bacteria. E. coli is most often found in foods such as meat, dairy products and juice. Its’ presence is often an indication of poor hygiene practice. Incidences of E. Coli infection have been reported when individuals have been swimming in pools or lakes contaminated with fecal matter.

Most children who suffer a bout of gastroenteritis make a full recovery and do not go on to develop hemolytic uremic syndrome.

Symptoms

  • Pale color

  • Fatigue and irritability

  • Small unexplained bruising

  • Bleeding from the nose or mouth

Unexplained bleeding may occur due to the destruction of platelets involved in the clotting process. These symptoms may not appear until a week after the initial bout of gastroenteritis.

As many as 50% of children with hemolytic uremic syndrome will go on to develop acute kidney failure – indicated by a decrease in urine output, where the urine will also appear to be red in color. The decrease in urine output is a result of the kidneys blood vessels becoming clogged; this means that the kidneys have to work harder in order to flush waste and excess fluid from the blood. When excess fluid and waste is not sufficiently expelled from the body the patient may experience high blood pressure and localized swelling in the hands, feet and face (swelling may also involve the whole body).

Clearly any child exhibiting any of these symptoms should be taken to the emergency room immediately.

Diagnosis

Initial diagnosis will be made after a full history has been taken and the child examined. It will then be confirmed after testing of the blood.

Treatment

  • Normalizing of salt and water levels in the body will ease immediate symptoms and should prevent further problems

  • IV blood transfusion

  • In severe cases dialysis may be necessary

Children who suffer a significant amount of kidney damage may go on to develop permanent kidney failure which will require long-term dialysis or a kidney transplant. There are indications from some research that a low protein diet and the use of ACE inhibitors may help delay, or even prevent the onset of permanent kidney failure.

Most children who develop hemolytic uremic syndrome make a full recovery with no long term complications.

Prevention

Since the initial infection which causes hemolytic uremic is due to the E. Coli bacteria it is clear that good hygiene practice will greatly reduce the risk of developing the condition. Food, especially meat products, should be washed and cooked properly. Hands should always be washed thoroughly after using the bathroom as well as before food preparation. Using unclean swimming areas should also be avoided.

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