Uremic Hemolytic Syndrome Definition, Reason, Symptoms, Treatment & Prevention
Definition
Hemolytic uremic syndrome is an immune system disorder that causes kidney failure, thrombocytopenia (low levels of platelets), and anemia (low levels of red blood cells). Disorders of the immune system most often occur after infection in the digestive tract.
Hemolytic uremic syndrome is the most common cause of acute kidney failure in children.
Uremic Hemolytic Syndrome Symptoms
Generally, hemolytic uremic syndrome is preceded by diarrhea. Often the diarrhea is bloody and accompanied by fever. Then 2–7 days after diarrhea, symptoms of acute kidney failure begin to appear.
Acute kidney failure is characterized by a smaller amount of urine than usual, urine mixed with blood, nausea and vomiting, and swollen stomach and limbs. The sufferer looks very limp. And if you don’t get treatment quickly, loss of consciousness or seizures can occur.
The excessive destruction of red blood cells that occurs in hemolytic uremic syndrome causes sufferers to look pale, weak, and lethargic. If the level of red blood cells is very low, complaints of shortness of breath and heart problems can occur.
Low platelet levels in hemolytic uremic syndrome make sufferers prone to bleeding. Bleeding most often occurs in the form of red spots or bruises on the skin. Apart from that, nosebleeds, bleeding gums, or bleeding from the digestive tract can also occur which is marked by vomiting blood or blackish bowel movements.
Uremic Hemolytic Syndrome Reason
The most common cause of hemolytic uremic syndrome is infection of the digestive tract, especially those caused by the following bacteria:
- Shigella dysentery
- Escherichia coli
- Salmonella typhi
- Campylobacter jejuni
- Neisseria meningitidis
- Streptococcus pneumonia
- Legionella sp
- Mycoplasma sp
In addition, viral infections, such as HIV, coxsackie virus, and influenza viruses can also trigger hemolytic uremic syndrome.
The toxins contained in the germs that cause digestive infections trigger an overreaction of the immune system. This results in excessive destruction of red blood cells and platelets. In addition, an excessive immune reaction also causes injury to the kidneys, leading to acute kidney failure.
Apart from gastrointestinal infections, in some cases, hemolytic uremic syndrome can also be triggered by the following conditions:
- Pregnancy and childbirth
- Certain types of cancer
- Side effects of several types of drugs, such as quinine, mitomycin, cisplatin, cyclosporin, and so on
- Autoimmune diseases such as lupus and antiphospholipid syndrome
- Kidney or bone marrow transplant
Diagnosis
During the initial examination, the doctor will conduct a complete interview and a thorough physical examination. Furthermore, several supporting examinations will be carried out, such as:
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Examination of urine analysis (urinalysis)
In patients with the hemolytic uremic syndrome, red blood cells and protein will usually be found in the urine. Under normal circumstances, there should be no protein or blood in the urine at all.
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Blood test
Examination of kidney function is necessary, in the form of examination of urea, creatinine, and examination of electrolytes. In addition, examination of hemoglobin (red blood cells) and platelets will also show results that are lower than normal. Excessive destruction of blood cells will also cause increased levels of bilirubin and lactate dehydrogenase (LDH).
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Stool culture examination
Stool culture is needed to specifically determine the bacteria that cause diarrhea and trigger hemolytic uremic syndrome.
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Ultrasound examination (USG)
Ultrasound examination is needed especially to see the picture of the kidneys. This examination cannot determine whether there is hemolytic uremic syndrome, but ultrasound is needed to see if there are other possible causes of kidney failure besides hemolytic uremic syndrome.
Uremic Hemolytic Syndrome Treatment
Treatment of hemolytic uremic syndrome includes:
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Replacement of fluids and electrolytes
Acute kidney failure that occurs in hemolytic uremic syndrome causes fluid and electrolyte balance to be disturbed. Therefore, fluid and electrolyte replacement through intravenous fluids is necessary.
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Blood transfusion
Red blood cell transfusions are generally given if the hemoglobin level reaches below 7 grams/deciliter, or the patient shows symptoms of shortness of breath due to anemia. Platelet transfusion is also needed if there is a condition of low platelets accompanied by bleeding that is difficult to stop.
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Dialysis (blood washing)
If the kidney disorder that is experienced is so severe that the kidneys can barely work at all, then dialysis is sometimes needed temporarily to replace the work of the kidneys.
Prevention
Because hemolytic uremic syndrome is most often triggered by digestive tract infections, by preventing these gastrointestinal infections, hemolytic uremic syndrome can generally be prevented. Some actions that can be taken are:
- Wash your hands with running water and soap every time you eat
- Eat thoroughly cooked food
- As much as possible, consume food in hot or warm conditions
- Do not swim in water that is dirty or contaminated with bacteria