Hemolytic-uremic syndrome

Hemolytic-uremic syndrome

    * Introduction
    * Pathogenesis
    * Signs and symptoms
    * Diagnosis
    * Treatment
Hemolytic uremic syndrome, hemorrhagic colitis, disease or infection enterica hamburger with Escherichia coli 0157: H7 triad consists of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. Hemolytic uremic syndrome clinical evolution varies from subclinical forms up to the life-threatening. Studies show distinct subgroups of the syndrome and have identified several etiologies for this disease. Hemolytic uremic syndrome is classified as non-associated diarrhea and diarrhea. This distinction is important because the clinical course and progression is different for each category.
Transmission was built between those who practice swimming, followed by transmission from person to person, animal contact, eating food and drinking water. Care Centres are places where the predominant transmission from person to person. Although contaminated meat is the most common transmission route for food, meets and transmission cabbage, apples, apple juice, salad, lettuce. Incidence is rising in the summer and early autumn. Epidemics of diarrhea followed by a hemolytic uremic syndrome was reported in institutions, schools and care homes. Seasonal variation is observed in hemolytic uremic syndrome without diarrhea.
Hemolytic syndrome with diarrhea diarrhea clinical picture shows that during the few days with vomiting, followed by sudden onset of symptoms of irritability and pallor. Over 80% of patients shows blood diarrhea. Other symptoms include restlessness, oliguria, edema, macroscopic hematuria. Hemolytic uremic syndrome without diarrhea may follow a respiratory infection but usually do not follow a prodrome. Haematological abnormalities include hemolysis, thrombocytopenia, purpura and petechiae. Patients have central nervous sistemiului changes including lethargy, irritability, coma, ataxia, seizures, hemiparesis. The ARF kidney shows.
The mortality rate decreased gradually. The improvement is attributed to better control of hypertension and acute renal failure during the acute stage of disease, using dialysis. The mortality rate remains high in undeveloped countries up to 72%. Hereditary hemolytic uremic syndrome, have a negative prognosis. The mortality rate is 90% in patients with autosomal dominant disease and 70% in patients with autosomal recessive form.
Successful therapy of the disease starts with early recognition and supportive treatment. Control includes managing fluid status, electrolyte abnormalities, hypertension and anemia. For acute renal dialysis indication. Blood hemoglobin abnormalities require maintenance treatment over 7g/dl. It indicates a blood transfusion, platelets, plasma.
Complications include hemolytic uremic syndrome: renal failure, behavioral changes, mental retardation, epilepsy, optic atrophy, focal motor deficit, diabetes mellitus, exocrine pancreatic insufficiency, intestinal necrosis, congestive heart failure, death. Prognosis depends on the nature of the syndrome. In general, patients with metabolic syndrome and diarrhea have a better prognosis than in those without diarrhea. Hemolytic uremic syndrome with diarrhea shows the following factors unfavorable evolution: high blood count at diagnosis, prolonged anuria, prolonged prodrome, severe hemorrhagic colitis with gangrene of the colony, severe multisystem disease, persistent proteinuria. Studies show that patients recover completely their renal function is good.