Hemolytic Uremic Syndrome

Diagnosis

Diagnosing hemolytic uremic syndrome typically requires a series of tests and a thorough physical examination. Each test is designed to detect different markers indicative of the syndrome. When the cause of HUS is unclear, further tests may be performed to pinpoint the underlying factors contributing to the condition.

Tests that may be ordered include:

• Blood tests: During the procedure, a tiny needle is used to take a blood sample from an arm vein. Blood tests provide information on red blood cell and platelet levels, offering insights into kidney and liver functionality. The test can detect damage to the red blood cells.
• Urine test: This test searches for the presence of blood or protein in the urine. A urine sample is often collected through a container. A dipstick is then inserted into the jar. If there is blood or protein in the urine, the color of the dipstick will change.
• Fecal test: This test is conducted to identify the existence of E. coli O157, and a kidney biopsy is performed to reveal any damage to the kidneys.

Treatment

Hemolytic uremic syndrome is treatable. Individuals diagnosed with HUS can achieve recovery without enduring lasting health consequences. Children usually recover better than adults, and more than 85% of people with HUS regain full kidney function.

To compensate for the kidneys’ inability to eliminate waste and fluids as well as they should, treatment entails replenishing lost minerals and fluids. It may also entail receiving nourishment via a vein. Hospitalization is required for treatment of hemolytic uremic syndrome.

• Medicines: For individuals with atypical hemolytic uremic syndrome, healthcare providers may recommend eculizumab or ravulizumab to prevent blood clots that could harm blood vessels, blood cells, and kidneys. A blood pressure-lowering medication may be used to treat hemolytic uremic syndrome-related kidney damage that lasts for a while.
  However, taking these medications increases the risk of meningococcal and pneumococcal diseases, so vaccinations and antibiotics may be prescribed.
• Transfusions: Red blood cell transfusions can be beneficial in alleviating symptoms of anemia, while platelet transfusions can improve blood clotting in individuals experiencing easy bruising or bleeding. This is often done intravenously while in the hospital.
• Surgery and other procedures: Certain procedures may help with treating hemolytic uremic syndrome, such as:
  • Plasma exchange: This procedure involves using a machine to eliminate the fluid part of blood, known as plasma, and replacing it with fresh or frozen donor plasma to facilitate the circulation of blood cells and platelets.
  • Kidney transplant: This may be necessary for individuals with severe kidney damage.
  • Kidney dialysis: Although dialysis is usually temporary, individuals with substantial kidney damage may require extended dialysis. The process requires removal of waste and excess fluid from the blood, typically performed until the kidneys regain normal function.