Hemolytic Uremic Syndrome in Emergency Medicine Follow-up

Updated: Jan 21, 2015
  • Author: Audrey J Tan, DO; Chief Editor: Steven C Dronen, MD, FAAEM  more...
  • Print
Follow-up

Complications

Complications of hemolytic uremic syndrome include the following:

  • Hypertension
  • Neurologic dysfunction including seizures, coma, stroke, hemiparesis, and cortical blindness: Severe CNS involvement is associated with significant mortality.
  • GI involvement, including any area from the esophagus to the anus: This can include hemorrhagic colitis, bowel necrosis/perforation, or intussusception.
  • Cardiac dysfunction, possibly precipitated by uremia and fluid overload
  • Complications involving the pancreas are seen in fewer than 10% of patients and can include glucose intolerance. Frank diabetes mellitus is rare.
  • Liver complications including hepatomegaly and/or increased serum transaminases levels are not uncommon.
  • In severe cases, death may be an inevitable outcome if the disease has progressed too far prior to presentation.
Next:

Prognosis

See the list below:

  • The overall mortality rate of hemolytic uremic syndrome (HUS) is 5-15%.
  • For unknown reasons, younger children who present in the summer with the typical diarrheal prodrome tend to do better than older children who develop HUS during the colder months of the year.
  • Adults with HUS generally have a poorer prognosis than children. In one study, 14% of adults with HUS succumbed to the disease. Adults who undergo kidney transplantation because of HUS are at much higher risk of graft loss than patients undergoing transplantation for other reasons. [8]
  • With supportive care, approximately 85% of patients recover and regain normal renal function.
  • Patients experiencing D- HUS have a poorer prognosis.
Previous