16470 Hemolytic Uremic Syndrome

Overview

Hemolytic uremic syndrome (HUS) is a rare but serious condition that mainly affects the kidneys and the blood. It happens when tiny blood vessels in the kidneys get damaged, which can cause red blood cells to be destroyed and block blood flow to the kidneys. This can lead to kidney problems and other complications.

No, HUS is rare. Doctors see it most often in small children, especially after a bout of diarrhea caused by a specific type of E. coli infection.

Children under the age of five are most likely to get HUS, but older children and adults can also develop it. In adults, it may be linked to other health conditions, certain medicines, pregnancy, or infections.

Symptoms

Common symptoms

• Diarrhea, which may be watery or bloody
• Vomiting
• Stomach pain
• Fever
• Feeling very tired or weak
• Less urine than normal
• Swelling in the face, hands, or feet

Symptoms in children

• Diarrhea (especially bloody) is often the first sign
• Crying or being fussy
• Feeling very sleepy or hard to wake
• Pale or yellow-tinged skin
• Bruising or tiny red or purple spots on the skin
• Decreased urine output

Symptoms in older adults

• Confusion or feeling very tired
• Shortness of breath
• Swelling in the legs and ankles
• High blood pressure
• Less urine than normal

Causes

Main causes

• Infection with a type of E. coli bacteria (called STEC), often from contaminated food, water, or contact with animals
• Some other infections, like pneumonia or HIV, can also trigger HUS
• Certain medicines (such as some chemotherapy or immune-suppressing drugs)
• Pregnancy or giving birth, in rare cases
• Inherited gene changes (this is rare)

Risk factors

• Being under 5 years old
• Eating undercooked ground beef or unpasteurized milk or juice
• Drinking from contaminated water sources
• Having close contact with farm animals, especially cows or goats
• Having a weakened immune system

When to see a doctor

See a doctor urgently if:

• If you or your child has bloody diarrhea, see a doctor urgently
• If there is noticeably less urine than normal
• If there is a lot of vomiting or belly pain
• If you notice swelling in the body or new bruising

Book a routine appointment if:

• If you have been diagnosed with HUS and have follow-up appointments to check kidney health
• If you have had HUS and have new symptoms such as tiredness or high blood pressure weeks later

Diagnosis

A doctor will ask about your symptoms, recent food exposure, and any contact with sick people or animals. They will do a physical exam and order blood and urine tests to check how your kidneys are working and look for signs of red blood cell damage.

Tests that may be done

• Blood tests to check kidney function, platelet count, and red blood cells
• Urine tests to look for blood or protein
• Stool test to check for E. coli infection
• Kidney biopsy (taking a tiny sample of kidney tissue) in some rare cases

What to expect at your appointment

Diagnosis usually happens in a hospital because HUS can become serious quickly. The doctor may explain that you or your child will need to stay in the hospital for monitoring and treatment. This is a standard way to manage HUS.

Treatment

There is no specific medicine to cure HUS. Treatment focuses on supporting the body, managing symptoms, and preventing complications while the kidneys heal. Most people with HUS need to be treated in a hospital, sometimes in an intensive care unit (ICU).

Self-care at home

• Drink plenty of fluids if your doctor advises it is safe
• Rest as much as possible
• Do not take medicines to stop diarrhea unless a doctor tells you to — some of them can make HUS worse
• Follow the care plan your healthcare team gives you

Medical treatments

Treatment may include IV fluids to keep the body hydrated, blood transfusions if there is severe anemia, and kidney dialysis if the kidneys stop working well enough. Dialysis is a machine that helps clean waste from the blood when the kidneys cannot. Some people may receive medicines to manage blood pressure or other complications. In certain cases, doctors may use a procedure called plasma exchange, where the liquid part of the blood is removed and replaced with healthy donor plasma.

Living with this condition

Recovery from HUS can take time. Some people feel better after a few weeks, but others may need months to regain strength. You or your child will likely need regular check-ups to monitor kidney function and blood pressure.

Lifestyle tips

• Attend all follow-up appointments
• Tell your doctor about any new symptoms, such as tiredness or swelling
• If high blood pressure develops, take steps to manage it, like reducing salt if your doctor advises
• Keep up good handwashing habits, especially after using the toilet and before eating

Diet and exercise

Your doctor or dietitian will guide you on food and fluids based on how your kidneys are working. If kidney function is normal, a balanced diet is usually fine. If the kidneys are weakened, you may need to limit certain foods, such as those high in salt, potassium, or protein. Light activity like walking is usually okay when you feel able, but always ask your healthcare team.

Mental health and emotional wellbeing

Being diagnosed with HUS — especially for a child — can feel frightening and stressful for the whole family. It is normal to feel anxious or overwhelmed. Talking to a psychologist or counsellor may help. Parents should also take care of their own mental health while supporting their child.

Prevention

Not always, but you can reduce the risk of getting the infections that often lead to HUS. This includes cooking meat thoroughly, avoiding unpasteurized milk, washing hands carefully, especially after touching animals, and ensuring water is safe to drink.

Vaccines

There is no vaccine specifically for HUS. Staying up to date with routine childhood vaccines can help prevent other infections that might lead to serious illness.

Screening programmes

There is no routine screening for HUS. It is diagnosed after symptoms appear.

Complications

If left untreated

• Severe kidney failure, which can be life-threatening
• High blood pressure that does not go away
• Chronic kidney disease that gets worse over time
• Seizures or other nervous system problems
• Stroke

Long-term outlook

The outlook for HUS is better now than in the past. With early and careful hospital care, most children recover without permanent kidney damage. However, some people may have lasting kidney problems or high blood pressure. Even after recovery, regular check-ups are important so any long-term issues can be caught early and managed well.

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