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What is Hemolytic Uremic Syndrome?

What is Hemolytic Uremic Syndrome? Perhaps someone you know and love has been diagnosed with this syndrome and now you need to know all of the details. I personally didn’t know what this was until recently and came upon it while doing research about E. coli infection. According to East Idaho News: Hemolytic uremic syndrome (HUS) is a rare but serious condition that primarily affects children and can lead to kidney failure. The syndrome is characterized by hemolytic anemia (the destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney injury. The most common cause of HUS in children is infection with certain strains of Escherichia coli (E. coli) bacteria. Hemolytic uremic syndrome has a prevalence of between 5% and 15% in people who have E. coli.

What are the Symptoms?

The Cleveland Clinic shares a great list of symptoms.

Hemolytic uremic syndrome symptoms include:

Diarrhea, usually bloody.
Fever.
Abdominal pain.
Vomiting.
Fatigue.
Easy bruising.
Pale skin or the linings of your nose and mouth (mucous membranes) are pale.
Confusion.
Seizures.
Stroke.

In severe cases of HUS, damaged red blood cells can clog the tissue in your kidneys. As a result, your kidneys can’t filter and eliminate waste from your body. If your kidneys can’t filter and eliminate waste, it can lead to acute kidney injury.

How Do People Get e. Coli?

E. coli usually enters your body when you eat spoiled, undercooked or poorly processed foods or drinks. These may include:

Undercooked meat (usually ground beef).
Unpasteurized milk or fruit juice.
Unwashed and contaminated raw fruits and vegetables.

E. coli can also spread from person to person through an oral-fecal route. “Oral-fecal” means that harmful strains of E. coli spread when people don’t wash their hands thoroughly with soap and water after they use the bathroom or touch feces (poop). You may touch poop after changing diapers or incontinence garments. You may also touch poop after petting zoo or farm animals that have soiled fur. If you have harmful E. coli bacteria on your hands, it can enter your system when it transfers to the food you eat, or you put your fingers in your mouth.

Of course to reiterate that only 5-15% of people who have E. coli actually get HUS so this would be quite uncommon, but still something that should be on the radar if you or someone you know has E. coli especially children. HUS is not contagious, but E. coli can be transmitted to many people after consuming contaminated food or beverages or contact with a person or anima’s fecal matter.

How is Hemolytic Uremic Syndrome Diagnosed?

Urine Tests
Blood Test
Genetic Testing– Your provider may send part of your blood sample to a lab for genetic testing. Genetic testing determines whether you have higher odds of developing HUS according to your genes (genetic tendency). This helps determine how long you may need therapies such as eculizumab or ravulizumab. If you have a genetic abnormality, you have a higher chance of requiring long-term therapy with eculizumab or ravulizumab.
Stool Sample/Test
Kidney Biopsy– While rare sometimes a kidney biopsy is done for this syndrome. Children don’t need this done but some adults do.

Tests look for the presence of different things that indicate hemolytic uremic syndrome.

Urine tests look for blood or protein in your pee. Blood tests detail your red blood cell levels and platelet levels. They can also tell your healthcare provider how well your kidneys and liver are functioning. Stool tests check for the presence of E. coli O157. A kidney biopsy shows damage to your kidney.

How is Hemolytic Uremic Syndrome Treated?

Hemolytic uremic syndrome treatment may include blood transfusions, especially red blood cells and platelets. Red blood cells help with signs and symptoms of anemia, including chills, fatigue, shortness of breath and rapid heart rate. Platelets help your blood clot, especially if you’re bleeding or bruising easily. You may have a greater chance of getting an infection during treatment, so it’s a good idea to wash your hands often and distance yourself from people with infections, including a common cold or the flu. Your healthcare provider may also give you intravenous (IV) fluids to keep you hydrated. If you have severe kidney failure, you may need dialysis to keep your blood clean while your kidneys heal. Dialysis is usually temporary.

Medications are often needed for blood pressure control if you have high blood pressure at the time you were diagnosed with HUS.

Do You Recover from Hemolytic Uremic Syndrome?

There is great news! More than 85% of people regain total kidney function. The downside is that sometimes blood pressure remains high requiring medication to maintain it and you are at a greater chance for other kidney problems in the future. It is noted that children have an easier time recovering from HUS than adults.

But question of the day is though how do you prevent HUS or reduce the chances that you will get it?

Avoid dirty swimming water
Do not swim if you have diarrhea
Do not consume unpasteurized drinks such as milk, cider or fruit juice
Keep all kitchen utensils clean as well as all food surfaces like your stove top and counters
Cook meats to their required internal temperature to ensure they are done
Defrost meats in the microwave or fridge. Do not sit on counters to defrost
Keep raw foods separate from cooked foods
Always wash your hands before eating
Wash your hands after changing a baby or caring for a family member or friend who is incontinent.
Wash your hands after using the restroom
Wash or sanitize your hands after visiting farm animals or caring for your own backyard farm friends