What is hemolytic uremic syndrome (HUS)?
HUS is a rare condition that can lead to kidney failure in children. Kidney failure develops as a result of destruction of the small, functional structures and vessels inside the kidney. HUS is a serious illness and potentially fatal. However, more than 85 percent of patients with the most common form of HUS recover complete kidney function.
Causes
HUS is more common during the summer months and may occur in outbreaks. Outbreaks have been reported in daycare centers, water parks, and fast food restaurants as a result of inadequately cooked hamburger meat.
HUS has several known causes and some unknown causes. Typically in children, HUS develops after an infection with the E. coli bacterium. E. coli may be found in contaminated food, such as dairy products and meat. HUS can also develop as a result of taking certain medications or may result from a cancer present in the body, although these causes are less common. Some rare cases of HUS are familial, which suggests a genetic predisposition.
Symptoms
The following are the most common symptoms of HUS. However, each child may experience symptoms differently.
The initial symptoms of HUS frequently last from one to 15 days and may include symptoms in the digestive tract, such as the following:
- Abdominal pain
- Bloody or watery diarrhea
- Vomiting
- Fever
Severe problems in the bowel and colon may develop in some cases. In these cases, even if the digestive symptoms are no longer present, a child may still exhibit the following symptoms:
- Irritability
- Fatigue
- Small, unexplained bruises visible in the lining of the mouth
- Pale skin
- Dehydration
Your child may produce little urine because damaged red blood cells and other factors may clog the tiny blood vessels in the kidneys, or cause lesions in the kidneys, making them work harder to remove wastes and extra fluid.
The body's inability to rid itself of excess fluid and waste may, in turn, cause the following symptoms:
- High blood pressure
- Swelling of the hands and feet
- Generalized fluid accumulation in the tissues (edema)
The symptoms of hemolytic uremic syndrome may resemble other medical conditions or problems. Always consult your child's doctor for a diagnosis.
Diagnosis
In addition to a complete medical history and physical examination, diagnostic procedures for hemolytic may include:
- Blood tests. Done to assess blood cell counts, electrolytes, and kidney function
- Urine tests. Done to check for blood and protein
- Stool tests. Done to assess for blood
- Abdominal X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
Treatment
Specific treatment for HUS will be determined by your child's doctor based on:
- Your child's age, overall health, and medical history
- The extent of the condition
- Your child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
There is no known treatment that can stop the progression of the syndrome once it has started. Initially, treatment may be supportive, which means that there is no cure for the specific disease, so it is necessary to treat the symptoms. If your child shows signs of dehydration and electrolyte irregularities, these conditions will be treated first. Other therapies may include:
- Intensive care. Close observation and monitoring in an intensive care unit (ICU) may be necessary.
- Blood transfusions. Blood transfusions may be necessary to treat moderate to severe cases of anemia (low red blood cell count).
- Nutrition. Your child may require intravenous (IV) nutrition if he or she is having severe digestive tract complications.
- Dialysis. Dialysis may be required in up to half of all children who develop HUS. Dialysis is a medical procedure to remove wastes and additional fluid from the blood after the kidneys have stopped functioning.
- Medication. Medications may be required to treat your child's blood pressure, which may be elevated.
Prevention
Completely cooking all foods that may contain hamburger meat can prevent HUS that is caused by E. coli. Other possible sources of E. coli include unpasteurized juices or milk.
If your child has HUS, it is important to notify your daycare center or your child's other close contacts (for example, play groups and school). HUS is not contagious, but spread of the E. coli bacterium is contagious.
Resources to help
Division of Nephrology Resources
We have created resources to help you find answers to your questions and feel supported as you help your child cope with this condition.
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Here at the Division of Nephrology, we are known for our ability to diagnose, treat and care for children with all forms of kidney disease. We offer superb clinical care and a compassionate, family-centered approach.