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Hemolytic Uremic Syndrome (cont.)

What is the treatment for hemolytic uremic syndrome?

HUS in children tends to be self-limiting, and supportive care is often all that is needed. This may include intravenous fluids for rehydration and rebalancing of electrolytes like sodium and potassium, which can be lost with the diarrhea.

Blood transfusion are only used for the most severe cases of anemia in which the hemoglobin falls below 6 or 7 g/dL (depending on age, the normal value is 11-16).

Kidney failure can be managed expectantly (by observation and supportive care), and dialysis is not often required.

Adults with HUS tend to become more ill and need more aggressive therapy than children with the condition. In addition to the supportive care discussed above, plasmapheresis or plasma exchange may be required. Since it is thought there is an abnormal chemical in the plasma stimulating the abnormal clot formation, removing the plasma and replacing it with donor plasma is helpful in treating adult HUS.

Temporary dialysis may be needed while awaiting recovery of the kidneys from the illness.

What is the outcome of hemolytic uremic syndrome?

HUS in children tends to be self-limiting, and full recovery should be expected.

Adults do less well. Without aggressive therapy like plasmapheresis and dialysis, up to 40% of those affected may die, and 80% may have kidney impairment. With treatment, the death rate falls to 10% or less and kidney impairment to 25%.

Patients with HUS not related to a diarrheal illness have a worse prognosis than those whose illness is due to an E. coli infection.

In those patients with genetically caused HUS, relapsing illness is common as are kidney failure requiring dialysis and death.

How can hemolytic uremic syndrome be prevented?

Most cases of E. coli-related HUS can be prevented by thorough cooking of hamburger products. The vast majority of cases of HUS are caused by poor food handling, and proper technique in the kitchen is the key to prevention.


Last Editorial Review: 1/11/2008




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