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Difference between revisions of "Hemolytic uremic syndrome"
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'''Hemolytic uremic syndrome''', abbreviated '''HUS''', is the triad of:<ref>URL: [http://emedicine.medscape.com/article/779218-overview http://emedicine.medscape.com/article/779218-overview]. Accessed on: 8 September 2010.</ref> | '''Hemolytic uremic syndrome''', abbreviated '''HUS''', is the triad of:<ref>URL: [http://emedicine.medscape.com/article/779218-overview http://emedicine.medscape.com/article/779218-overview]. Accessed on: 8 September 2010.</ref> | ||
*Microangiopathic hemolytic anemia. | |||
*Thrombocytopenia. | ==Definition== | ||
*Microangiopathic hemolytic [[anemia]]. | |||
**Microangiopathic = disease affecting small blood vessels.<ref>URL: [http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm]. Accessed on: 9 September 2010.</ref> | |||
*Thrombocytopenia = low platelet count. | |||
*Acute renal failure. | *Acute renal failure. | ||
===Memory device=== | |||
''[[HUS]] is the '''RAT''' in [[TTP]]'': | |||
*'''R'''enal failure. | |||
*'''A'''nemia. | |||
*'''T'''hrombocytopenia. | |||
'''RAT''' is a subset of the C'''RA'''F'''T'''Y mnemonic for TTP:<ref>URL: [http://www.valuemd.com/mnemonics2.php http://www.valuemd.com/mnemonics2.php]. Accessed on: 8 November 2010.</ref> | |||
*'''C'''NS symptoms. | |||
*'''R'''enal failure. | |||
*'''A'''nemia - microangiopathic hemolytic anemia. | |||
*'''F'''ever. | |||
*'''T'''hrombocytopenia. | |||
*'''Y''' - no one knows "Y" it occurs. | |||
==Etiology== | ==Etiology== | ||
*Verotoxins | *Rare (uncooked) hamburger. | ||
*''E. coli'' serotype O157:H7. | |||
**Verotoxins from ''E. coli'' O157:H7 --> endothelial injury.<ref name=pmid19180125>{{cite journal |author=Petruzziello TN, Mawji IA, Khan M, Marsden PA |title=Verotoxin biology: molecular events in vascular endothelial injury |journal=Kidney Int. Suppl. |volume= |issue=112 |pages=S17–9 |year=2009 |month=February |pmid=19180125 |doi=10.1038/ki.2008.612 |url=}}</ref> | |||
==Relation to thrombotic thrombocytopenic purpura (TTP)== | ==Pathology== | ||
===General=== | |||
*In children, partial [[omentum|omentectomies]] are done during the placement of peritoneal catheters, to avoid subsequent (catheter) blockage.<ref name=pmid7838254>{{cite journal |author=Pumford N, Cassey J, Uttley WS |title=Omentectomy with peritoneal catheter placement in acute renal failure |journal=Nephron |volume=68 |issue=3 |pages=327–8 |year=1994 |pmid=7838254 |doi= |url=}}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Mesothelial-lined fibroadipose tissue. | |||
==Relation to [[thrombotic thrombocytopenic purpura]] (TTP)== | |||
*TTP is the main (clinical) DDx of HUS. | *TTP is the main (clinical) DDx of HUS. | ||
**It is classically characterized by: microangiopathic hemolytic anemia, thrombocytopenia, fever, mild renal failure, and prominent neurologic symptoms. | **It is classically characterized by: microangiopathic hemolytic anemia, thrombocytopenia, fever, mild renal failure, and prominent neurologic symptoms. | ||
*Both are classified as ''thrombotic microangiopathies''.<ref>URL: [http://emedicine.medscape.com/article/779218-overview http://emedicine.medscape.com/article/779218-overview]. Accessed on: 8 September 2010.</ref> | *Both are classified as ''[[thrombotic microangiopathies]]''.<ref>URL: [http://emedicine.medscape.com/article/779218-overview http://emedicine.medscape.com/article/779218-overview]. Accessed on: 8 September 2010.</ref> | ||
==See also== | ==See also== | ||
*[[Medical kidney diseases]]. | *[[Medical kidney diseases]]. | ||
*[[Anemia]]. | |||
==References== | ==References== | ||
{{reflist| | {{reflist|2}} | ||
[[Category:Genitourinary pathology]] | [[Category:Genitourinary pathology]] | ||
[[Category:Diagnosis]] | |||