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; microangiopathic<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> = disease affecting small blood vessels.
 
*Thrombocytopenia; low platelet count.  
==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==
Line 9: Line 26:
**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>
**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|1}}
{{reflist|2}}


[[Category:Genitourinary pathology]]
[[Category:Genitourinary pathology]]
[[Category:Diagnosis]]

Latest revision as of 04:56, 2 April 2012

Hemolytic uremic syndrome, abbreviated HUS, is the triad of:[1]

Definition

  • Microangiopathic hemolytic anemia.
    • Microangiopathic = disease affecting small blood vessels.[2]
  • Thrombocytopenia = low platelet count.
  • Acute renal failure.

Memory device

HUS is the RAT in TTP:

  • Renal failure.
  • Anemia.
  • Thrombocytopenia.

RAT is a subset of the CRAFTY mnemonic for TTP:[3]

  • CNS symptoms.
  • Renal failure.
  • Anemia - microangiopathic hemolytic anemia.
  • Fever.
  • Thrombocytopenia.
  • Y - no one knows "Y" it occurs.

Etiology

  • Rare (uncooked) hamburger.
  • E. coli serotype O157:H7.
    • Verotoxins from E. coli O157:H7 --> endothelial injury.[4]

Pathology

General

  • In children, partial omentectomies are done during the placement of peritoneal catheters, to avoid subsequent (catheter) blockage.[5]

Microscopic

Features:

  • Mesothelial-lined fibroadipose tissue.

Relation to thrombotic thrombocytopenic purpura (TTP)

  • 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.
  • Both are classified as thrombotic microangiopathies.[6]

See also

References

  1. ↑ URL: http://emedicine.medscape.com/article/779218-overview. Accessed on: 8 September 2010.
  2. ↑ URL: 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.
  3. ↑ URL: http://www.valuemd.com/mnemonics2.php. Accessed on: 8 November 2010.
  4. ↑ Petruzziello TN, Mawji IA, Khan M, Marsden PA (February 2009). "Verotoxin biology: molecular events in vascular endothelial injury". Kidney Int. Suppl. (112): S17–9. doi:10.1038/ki.2008.612. PMID 19180125.
  5. ↑ Pumford N, Cassey J, Uttley WS (1994). "Omentectomy with peritoneal catheter placement in acute renal failure". Nephron 68 (3): 327–8. PMID 7838254.
  6. ↑ URL: http://emedicine.medscape.com/article/779218-overview. Accessed on: 8 September 2010.
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