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Hemolytic uremic syndrome, life-threatening condition for children

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Abraham Eisenstein, M.D. |
HUS
E. coli O157:H   A major foodborne pathogen causing severe disease

Hemolytic uremic syndrome (HUS) can be spread directly from person to person, particularly in child day-care facilities, and from animal to person. HUS is the most common cause of sudden loss of kidney function in children.

The kidneys, organs that filter our blood to remove toxins, have glomeruli, tiny parts that work as filters.

When those parts become clogged with the damaged red blood cells, they lose their function and can't filter blood anymore. When that happens and a loss of kidney function occurs, the situation becomes very bad.

The most common cause of HUS in children is an Escherichia coli infection.

E. coli can be found in the digestive system and its harmless types lives happily in the body, causing no problem whatsoever.

But, if a child is infected with one specific type - O157:H - the bacteria will start to produce toxins in the digestive tract. After that, it will enter the bloodstream and toxins are destroying the red blood cells.

Now, it's not hard to find O157:H at all. It survives well in the environment and cattle are its natural reservoir. Sheep, goats, pigs, and turkeys have also been found to shed E. coli O157:H7 in their feces.

It can enter the body from meat that's not properly cooked, raw milk, unwashed raw fruits and vegetables, or contaminated swimming waters. In short, it can be found in food and places children love.

But, there is also atypical hemolytic uremic syndrome, another condition that can be caused by chemotherapy, viral or bacterial infections, and there is also a genetic factor that runs in the family.

Hemolytic uremic syndrome occurs in about two out of every 100,000 children, so it's not very common but it can be very dangerous.

A child with hemolytic uremic syndrome may have following symptoms: vomiting, bloody diarrhea, abdominal pain, fever and chills, or headache.

Since those symptoms are similar to those in some other stomach inflammation, a complete test in the hospital is needed to confirm it's about HUS.

And when hemolytic uremic syndrome causes acute kidney injury, there are other serious symptoms: swelling in the legs, albuminuria — when a child's urine has high levels of albumin protein, hypoalbuminemia — when a child's blood has low levels of albumin, decreased urine output, or blood in the urine.

Since the condition can be fatal, immediate help is necessary when a kid experiences swelling, extreme fatigue, decreased urine output, unexplained bruises, or unusual bleeding.

This is the condition that may be treated very well if diagnosed on time and if the kid has normal, healthy immune system in most cases she/he will recover without any further complications.

However, where there are complications, they can be very serious: acute kidney injury, blood-clotting problems, seizures, stroke, or chronic kidney disease.

In milder cases, the doctor will give the child IV with minerals and fluids, supply with red blood cells and platelets that help with clotting, treat high blood pressure with medications, and will closely monitor the patient.

In more severe cases, when kidney failure occurs, the course of action is dialysis - filtering wastes and extra fluid from the body with an artificial kidney - or kidney transplantation.

The best way to childhood hemolytic uremic syndrome is to make sure that E. coli O157:H7 stays away from kids.

That can be done by avoiding unpasteurized milk and juice, avoiding raw meat - that's a very bad practice by itself, keeping raw and cooked meat separate, washing hands before every meal, avoiding swimming in areas for which we are not sure they are clean, and cleaning food surfaces regularly.


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