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Hemolytic Uremic Syndrome: Another FAT RN?

  • Seth Klein
  • Colin G. KaideEmail author
Chapter

Abstract

Hemolytic uremic syndrome (HUS) is a member of a larger group called thrombotic-microangiopathies (TMA). HUS leads to endothelial injury, platelet activation, and vaso-occlusive fibrin and platelet thrombi accumulation that lead to destruction of red blood cells and injury to the brain, heart, lungs, GI tract, and kidneys. HUS can result from shiga toxin exposure or from a defect in complement activity.

Keywords

Hemolytic uremic syndrome Shiga toxin Atypical hemolytic uremic syndrome E. coli 0157:H7 Plasmapheresis Autoimmune Complement system 

Notes

Disclosure Statement

Klein—Nothing to disclose

Kaide—Callibra, Inc.-Discharge 123 medical software company. Medical Advisory Board Portola Pharmaceuticals. I have no relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product.

References

  1. 1.
    Tsai HM. Autoimmune thrombotic microangiopathy: advances in pathogenesis, diagnosis, and management. Semin Thromb Hemost. 2012;38:469–82.CrossRefGoogle Scholar
  2. 2.
    Cody EM, Dixon BP. Hemolytic uremic syndrome. Pediatr Clin N Am. 2019;66(1):235–46.  https://doi.org/10.1016/j.pcl.2018.09.011.CrossRefGoogle Scholar
  3. 3.
    Noris M, Remuzzi G. Atypical hemolytic-uremic syndrome. N Engl J Med. 2009;361(17):1676–87.CrossRefGoogle Scholar
  4. 4.
    Scheiring J, Andreoli SP, Zimmerhackle LB. Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS). Pediatr Nephrol. 2008;23:1749–60.CrossRefGoogle Scholar
  5. 5.
    Besbas N, Karpman D, Landau D, Loirat C, Proesmans W, Remuzzi G, Rizzoni G, Taylor CM. A classification of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura and related disorders. Kidney Int. 2006;70:423–31.CrossRefGoogle Scholar
  6. 6.
    Nolasco LH, Turner NA, Bernardo A, Tao Z, Cleary TG, Dong J, Moake JL. Hemolytic uremic syndrome-associated Shiga toxins promote endothelial-cell secretion and impair ADAMTS13 cleavage of unusually large von willebrand factor multimers. Blood. 2005;106:4199–209.  https://doi.org/10.1182/blood-2005-05-2111.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hodgkins KS, Bobrowski AE, Lane JC, Langman CB. Clinical grand rounds: atypical hemolytic uremic syndrome. Am J Nephrol. 2012;35:394–400.CrossRefGoogle Scholar
  8. 8.
    Noris M, Remuzzi G. Hemolytic uremic syndrome. J Am Soc Nephrol. 2005;16(4):1035–50.CrossRefGoogle Scholar
  9. 9.
    Nitschke M, Sayk F, Härtel C, et al. Association between azithromycin therapy and duration of bacterial shedding among patients with Shiga toxin-producing enteroaggregative Escherichia coli O104:H4. JAMA. 2012;307(10):1046–52.CrossRefGoogle Scholar
  10. 10.
    Tarr PI, Gordon CA, Chandler WL. Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet. 2005;365(9464):1073–86.PubMedGoogle Scholar
  11. 11.
    McNamara LA, Topaz N, Wang X, Hariri S, Fox L, MacNeil JR. High risk for invasive meningococcal disease among patients receiving eculizumab (Soliris) despite receipt of meningococcal vaccine. MMWR Morb Mortal Wkly Rep. 2017;66:734–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Emergency Medicine, Wexner Medical Center at The Ohio State UniversityColumbusUSA

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