Hemolytic Uremic Syndrome

What is Hemolytic Uremic Syndrome?

The Hemolytic Uremic Syndrome is a condition that involves the disease process of hemolytic anemia, uremia and thrombocytopenia or low platelet count. Hemolytic anemia is possible for there is destruction of the red blood cells.

The epidemiological study of hemolytic uremic syndrome provided us a result of increased incidence among patients’ ages six months to four years. The condition was made known when there was an outburst of E. coli contamination. In the United States, about 183 cases where noted of E. coli infection and about 29 cases were positive of hemolytic uremic syndrome. It has also been estimated that cases of hemolytic uremic syndrome in the US is an approximate 2.1 cases of 100,000 people. Another report presented about 29 patients died from an E. coli outbreak that resulted to hemolytic uremic syndrome. It has also been reported that the most affected are the young and the elderly. Prognosis also depends on the affected and the severity of the condition. But approximately, about 3-5% mortality rate is the result of hemolytic uremic syndrome.

Diagnosis of the condition can be done through these laboratory tests. Blood tests can identify for presence of anemia and thrombocytopenia. Blood clotting test would help or assist us in the diagnosis of liver problems. Urinalysis is also another diagnostic exam that can identify for presence of blood in the urine. Not as always indicated, kidney biopsy is made necessary in some cases to rule out other possible conditions. Stool culture is also done in order to identify for presence of the bacterial agent, E. coli.

Symptoms

The condition, hemolytic uremic syndrome is characterized by the following classical manifestations:

• Bloody diarrhea – this is caused by the causative agent E. coli.
• Melena – the difference between melena and bloody diarrhea is that in melena these are formed feces with observable blood while bloody diarrhea is loose stools with blood.
• Oliguria – decreasesd urine output. There is also a tendency that the client shall experience absent urine output.
• Hematuria – blood-stained urine.
• Hemolytic anemia – this would be the destruction of the red blood cells that results to anemia.
• Uremia – the kidney’s function have been altered causing for increased waste products such as creatinine. The creatinine should be excreted from the body normally and should not stay in a person’s system in high levels.
• Neurological changes – uremia’s result to the patient. The accumulation of creatinine in the body can result to this. Profound neurological changes were reported.
• Thrombocytopenia – decreased platelet count.
• Renal failure – the kidney’s function become overworked that it compensates too much resulting to the depletion of its proper function.
• Hypertension, body malaise or weakness is manifested by the affected.
• Nausea and vomiting is supposed to be experienced by clients.

Causes

The condition hemolytic uremic syndrome is typically caused by a gastrointestinal bacterial infection named E. coli. This causative agent is known to cause for other GI problems such as the famous salmonella and shigella. The condition is believed to be acquired by undercooked meat which is contained by the bacteria E. coli. Women are at risk for developing hemolytic uremic syndrome when they are pregnant. The exact mechanism of the condition related to pregnancy is not made known, but case reports that pregnant women developed hemolytic uremic syndrome. Others are also at risk especially when they have acquired pneumonia from the bacteria Streptococcus pneumoniae. Those immunocompromised patients such as those with AIDS are also affected of the disease.

Treatment

The goal for the treatment course of hemolytic uremic syndrome is to lessen the infection. Here are the following medical remedies for hemolytic uremic syndrome:

Monoclonal antibodies

These are indicated for treating hemolytic uremic syndrome. This shall assist in the normal process of renal function.

Antibiotic

Treatment for E. coli is done by the giving of antibiotics.

Dialysis

This may be needed as renal failure is one of the common manifestations of the disease.

Plasmapharesis

This is a treatment of choice for hemolytic uremic syndrome.

Blood transfusion

As thrombocytopenia is manifested, transfusions of fresh frozen plasma.

Prevention

One should be careful with what they eat. Food preparation should also be observed clean so that incidence of acquiring the bacterial agent shall be far from happening. Health teaching is also essential in the process so that future cases shall be avoided or decreased.

As proper treatment has been provided to the client, their chance of surviving the disease process is high. About 90% is the survival rate for clients who are at their acute phase. Worst case scenarios include patients having about 9% chance of developing end stage renal disease, a hard to manage medical condition. Other patients even require a life-long treatment of hemodialysis as the case have gone to its worst. Complications such as uncontrolled high blood pressure, paralysis and even blindness are noted.