Hemolytic uremic syndrome (HUS)

Diagnosis

A physical exam and lab tests can confirm a diagnosis of hemolytic uremic syndrome. Lab tests might include:

• Blood tests. These tests can show if the red blood cells are damaged. Blood tests also can show a low platelet count, low red blood cell count or a higher than usual level of a waste product usually removed by the kidneys, called creatinine.
• Urine test. This test can find unusual levels of protein and blood and signs of infection in urine.
• Stool sample. This test might find E. coli and other bacteria in stool.

If the cause of hemolytic uremic syndrome isn't clear, other tests might help find the cause.

Treatment

Hemolytic uremic syndrome needs treatment in the hospital. Treatment involves replacing lost fluids and minerals to make up for the kidneys not removing fluids and waste as well as usual. It also might involve getting nutrition through a vein.

Transfusions

In the hospital, you might receive red blood cells or platelets through a vein, a process called a transfusion.

• Red blood cells can help reverse symptoms of anemia.
• Platelets can help blood clot better in people who are bleeding or bruising easily.

Medicines

Lasting kidney damage from hemolytic uremic syndrome might be treated with a medicine to lower blood pressure. This medicine might prevent or slow more kidney damage.

For complications or the atypical form of hemolytic uremic syndrome, treatment might include a medicine called eculizumab (Soliris) to help prevent more damage to the blood vessels.

Anyone taking eculizumab needs to have a vaccination to prevent meningitis, a possible serious side effect of the medicine.

Surgery and other procedures

Depending on the symptoms, the cause of hemolytic uremic syndrome and whether there are complications, treatment might include:

• Kidney dialysis. Dialysis removes waste and extra fluid from the blood. Dialysis is often done only until the kidneys begin working well again. But people with a lot of kidney damage might need long-term dialysis.
• Plasma exchange. Plasma is the fluid part of blood that helps blood cells and platelets circulate. 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 hemolytic uremic syndrome need a kidney transplant.

Preparing for your appointment

If you or your child has diarrhea for several days, call someone on your care team right away. Be ready to answer these questions:

• Have you seen 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 having 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, try to replace lost fluids with an oral rehydrating solution, such as Ceralyte, Pedialyte or Oralyte.