Published: 18 Jun 2025

ICD9: 283.11      ICD10: D59.3      ICD11: 3A21.2

Hemolytic Uremic Syndrome (HUS) is a serious condition that primarily affects children, but can also occur in adults.
It's characterized by a triad of problems:

Hemolytic anemia: Destruction of red blood cells (RBCs).
Acute kidney failure (uremia): Damage to the kidneys, leading to their inability to filter waste products from the blood.
Thrombocytopenia: Low platelet count in the blood, which can lead to bleeding problems.

Key Aspects of HUS:

Cause: The most common cause of HUS is infection with certain strains of Escherichia coli (E. coli) bacteria, particularly E. coli O157:H7. These bacteria produce a toxin called Shiga toxin (also known as verotoxin or Shiga-like toxin) that damages the lining of blood vessels, especially in the kidneys. This is often referred to as Shiga toxin-producing E. coli (STEC)-HUS or diarrhea-associated HUS (D+ HUS). Other less common causes include:

Non-E. coli bacterial infections (e.g., *Shigella*, *Salmonella*)
Certain medications (e.g., some chemotherapy drugs, immunosuppressants)
Genetic mutations affecting the complement system (atypical HUS, aHUS)
Pregnancy
Autoimmune disorders
Stem cell or organ transplantation
Transmission (for STEC-HUS): STEC-HUS is typically acquired by:
Eating contaminated food, such as undercooked ground beef, unpasteurized milk or juice, and raw vegetables.
Drinking contaminated water.
Direct contact with infected animals or people.
Swallowing contaminated water while swimming.
Symptoms:
Diarrhea: Often bloody, preceding other symptoms.
Abdominal pain
Vomiting
Fatigue and irritability
Pale skin (due to anemia)
Decreased urination
Swelling (especially in the face, hands, and feet)
Bruising or bleeding easily
Seizures (in severe cases)
Diagnosis: Diagnosis is based on:
Blood tests: To check for anemia, thrombocytopenia, kidney function (creatinine, BUN), and presence of STEC.
Stool culture: To identify the presence of E. coli O157:H7 or other pathogens.
Urine test: To check for kidney damage.
Genetic testing: Can be helpful in cases of atypical HUS.
Treatment: Treatment is primarily supportive and aimed at managing the complications of HUS.
Hospitalization: Usually required.
Fluid and electrolyte management: To correct imbalances.
Blood transfusions: To treat anemia.
Dialysis: To support kidney function if it is severely impaired.
Plasma exchange (plasmapheresis) or eculizumab: May be used in cases of atypical HUS or severe STEC-HUS.
Avoiding antibiotics: Antibiotics are generally *not* recommended for STEC-HUS, as they may increase the release of Shiga toxin and worsen the condition.
Prognosis: The prognosis varies depending on the severity of the condition and the underlying cause. Most children with STEC-HUS recover fully, but some may experience long-term kidney damage or other complications. Atypical HUS can have a more severe course.
Prevention (for STEC-HUS):
Cook meat thoroughly: Especially ground beef, to an internal temperature of 160°F (71°C).
Wash hands thoroughly: Before and after handling food, after using the restroom, and after contact with animals.
Avoid unpasteurized milk and juice.
Wash raw fruits and vegetables thoroughly.
Drink safe water.
Avoid swallowing water while swimming.
Practice good hygiene.

Important Note: HUS is a serious medical condition that requires prompt diagnosis and treatment. If you suspect that you or someone you know may have HUS, seek medical attention immediately. Don't try to self-diagnose or treat this condition.

The information provided here is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.