A 4 year old child presented with decreased urine output for last 20 hours & petechial spots over the body. There was a history of diarrhea 2 weeks prior to this. Blood investigations revealed a Hb level of 7 g/dl, TLC 11,800/mm3, Platelet count of 35,000/mm3. His peripheral smear fndings are shown below What is the diagnosis?
Peripheral smear showing schistocytes in a child with oliguria, thrombocytopenia, anemia & a history of recent diarrhea suggest a diagnosis of Hemolytic uremic syndrome (HUS) Shiga-toxin producing E. coli (STEC) and Shigella dysentriae type 1 are usual causes of HUS in children. Hemolytic-uremic syndrome (HUS) is a common cause of community acquired acute kidney injury in young children characterised by a triad of Microangiopathic Hemolytic anemia Thrombocytopenia Renal insufficiency Laboratory findings: low hemoglobin level, decreased platelet count, hypoalbuminemia, and hemolysis on peripheral smear (burr cells, helmet cells, schistocytes) Urinalysis reveals hematuria and proteinuria. A marked reduction of renal function leads to oliguria and rising levels of blood urea nitrogen (BUN) and creatinine Other options in the question: Malaria- Presents with fever, chills & rigors, pain in limbs. Peripheral Blood Film shows malarial parasite. ITP - comes with h/o fever, sudden appearance of bruises & mucosal bledding Acute tubular necrosis- oliguria, edema, hypeension.
Malaria
Idiopathic thrombocytopenic purpura
Henoch Schonlein Purpura
Hemolytic uremic syndrome
Acute and Chronic Kidney Disease