Diagnosis
To confirm a diagnosis of HUS, your doctor is likely to perform a physical exam and recommend lab tests, including:
- Blood tests. These tests can determine if your red blood cells are damaged. Blood tests can also reveal a low platelet count, low red blood cell count or a higher than normal level of creatinine, a waste product normally removed by your kidneys.
- Urine test. This test can detect abnormal levels of protein, blood and signs of infection in your urine.
- Stool sample. This test might detect toxin-producing E. coli and other bacteria that can cause HUS.
If the cause of HUS is not clear, your doctor may also recommend additional tests to help determine the cause.
Treatment
HUS requires treatment in the hospital. Lost fluids and electrolytes must be carefully replaced because the kidneys aren't removing fluids and waste as efficiently as normal.
Transfusions
In the hospital, you may need intravenous (IV) transfusions of red blood cells or platelets.
- Red blood cells can help reverse signs and symptoms of anemia — including chills, fatigue, shortness of breath, rapid heart rate, yellow skin and dark urine.
- Platelets can help your blood clot more normally if you're bleeding or bruising easily.
Medications
If you have lasting kidney damage from HUS, your doctor might recommend a medication to lower your blood pressure, to prevent or delay further kidney damage.
If you develop complications or have the form of HUS that's caused by a genetic mutation (atypical HUS), your doctor may recommend eculizumab (Soliris) to help prevent additional damage to your blood vessels.
Before taking eculizumab, you will need to receive or have already received a vaccination to prevent meningitis, a potential and serious side effect of the medicine.
Surgery and other procedures
Depending on your symptoms, the cause of your HUS and whether you have any complications, your doctor may recommend other treatments, including:
- Kidney dialysis. Sometimes dialysis is needed to filter waste and excess fluid from the blood. Dialysis is usually a temporary treatment until the kidneys begin functioning adequately again. But if you have significant kidney damage, you might need long-term dialysis.
- Plasma exchange. Plasma is the fluid part of blood that supports the circulation of blood cells and platelets. Sometimes a machine is used to clear the blood of its own plasma and replace it with fresh or frozen donor plasma.
- Kidney transplant. Some people who have severe kidney damage from HUS eventually will need a kidney transplant.
Preparing for your appointment
If you or your child is experiencing symptoms of HUS after several days of diarrhea, call your doctor immediately and be prepared to answer these questions:
- Have you noticed blood in the diarrhea?
- Have you or your child had a fever, swelling or decreased urine output?
- How long have you or your child been experiencing these symptoms?
- How long has it been since you or your child urinated?
What you can do in the meantime
If you or your child has an illness that causes vomiting or diarrhea, it's a good idea to try to replace the fluids that have been lost with an oral rehydrating solution, such as CeraLyte, Pedialyte or Oralyte.