Hemolytic uremic syndrome is a serious condition caused due to gastrointestinal infection, specifically after E. coli infection. The condition is characterized by triad of symptoms that include hemolytic anemia, low platelet count in blood and acute kidney failure. The disease is more common in children below the age of 5 after severe diarrhea caused by strain of E. coli O157:H7 bacteria. In adults hemolytic uremic syndrome can develop due to E. coli infection, certain medicines or pregnancy.
Transmission of E. coli bacteria occurs from eating and drinking contaminated food and water. The bacteria can also spread through close contact with an infected patient.Although a serious condition, prompt and proper treatment can lead to complete recovery from the illness without leaving any residual kidney damage.
What Causes Hemolytic Uremic Syndrome?
The most common cause of hemolytic uremic syndrome particularly in children below the age of 5 is an infection of E. coli bacteria in gastrointestinal system. The bacteria produces Shiga toxin, especially the strain called E. coli O157:H7. Some other strains are also known to cause hemolytic uremic syndrome. There are several strains of E. coli bacteria in the intestine of a healthy human but they are harmless.However, some strains of E. coli as those causing hemolytic uremic syndrome are harmful. E. coli bacteria and are found in contaminated meat and contaminated water. The organism enters into the GI tract after consuming contaminated food and water.
The toxin released by the bacteria acts upon the immune system and starts destroying the red blood cells and platelets. The filtering system of the kidney gets blocked by too many premature dead red blood cells and platelets. This leads to acute renal failure. The kidney is also injured due to immune reaction.
In adults besides E. coli infection, there are other causes that may trigger hemolytic uremic syndrome. They are: Infections such as HIV, medicines like quinine, chemotherapy and medicines used to suppress immunity, birth control pills and in rare cases pregnancy can also cause hemolytic uremic syndrome.
Signs And Symptoms Of Hemolytic Uremic Syndrome
The symptoms of hemolytic uremic syndrome are as follows:
- Patient may have bloody diarrhea.
- Cramps and pain in abdomen.
- Abdominal distension
- Pale face, lips and hands.
- Decreased urination. The urine output is very low as the function of kidney is hampered.
- Excessive thirst
- Skin cold and clammy.
- Unexplained bruises on skin.
- Bleeding from gums and nose due to low level of platelet count.
- Confused state of mind due to electrolyte imbalance caused by severe diarrhea.
- High blood pressure
- Swelling of limbs and face.
- Increased irritability. Some patients do not like noises or light and they like to stay in one room silently.
Treatment Of Hemolytic Uremic Syndrome
Hemolytic uremic syndrome treatment needs to be done in a hospital. Treatment includes supportive measures such as managing anemia, fluid and electrolyte imbalance, clinical bleeding, high blood pressure etc.
- Management of anemia: In order to correct anemia, patient may need red blood transfusion.
- Fluid replacement is done carefully because the kidneys are not functioning properly hence removal of excess fluid may need more careful management.
- Some patients may need transfusion of platelets to prevent bleeding and bruising from different organs.
- If kidneys are not functioning, dialysis may be needed to clear out waste from the body. In majority of cases long term dialysis is not needed.
Most people, especially children recover well from hemolytic uremic syndrome after proper treatment.