Hemolytic uremia syndrome
90 % of the patients had thrombocytopenia, which was mainly caused by the increase of peripheral destruction. The platelet survival time was shortened from the normal 7 - 10 days to 1.5 - 5 days. Thrombocytopenia usually lasts for 7 to 14 days, with a few recovering slowly. There is a tendency to bleed due to thrombocytopenia, manifested as epistaxis, gum bleeding, skin petechiae or small hematoma, hematemesis, hematochezia, hemoptysis, eyeground bleeding, and even cerebral hemorrhage.
Renal damage leads to acute renal failure with varying degrees of severity. In light cases, only temporary urine volume decreases and mild renal function decreases, sometimes called laboratory hemolytic uremic syndrome. The heavy ones are oliguria type. Oliguria lasts for 2 days to 8 weeks. Urine tests include protein, red, white blood cells and cast. At the same time, other symptoms of acute renal failure appear, such as azotemia, hyperkalemia, metabolic acidosis, high blood volume, hypertension, etc. Hyperuricemia is easy to occur because a large number of hemolyzed red blood cells destroy and release uric acid. In some cases patients died of congestive heart failure, arrhythmia and cardiac arrest caused by severe anemia, oliguria, hypertension and electrolyte disorders. The incidence of HUS chronic renal failure is 10 % ~ 40 %, which requires long-term dialysis treatment to maintain life.
HUS can affect the central nervous system. Some patients have neuropsychiatric symptoms of varying degrees, such as headache, drowsiness, irritability, muscle tremors, convulsions, and even coma. Some cases left neurological sequelae, such as abnormal behavior, learning difficulties, severe mental retardation, and even seizures.
Those who invade the heart cause myocardial necrosis due to microvascular thrombosis in the heart muscle, causing heart failure and arrhythmia, and those who are serious have sudden death. Pulmonary microvascular thrombosis can lead to chest distress, hemoptysis, pulmonary insufficiency and other manifestations.
Article by : Peking Tung Shin Tang Chinese Medical Hospital
Tag: uremia ,Hemolytic ,thrombocytopenia