All are features of haemolytic uremic syndrome, except?
Ans. is 'd' i.e., Neuropsychiatric manifestations Hyperkalemia is seen in hemolytic urenic syndrome as a result of renal failure. ABOUT NEUROPSYCHIATRIC MANIFESTATIONS Neurological manifestations are used to distinguish between Hemolytic uremic syndrome and Thrombotic Thrombocytopenic Purpura. H.U.S. is distinguished from T.T.P by the absence of neurological symptoms and the prominence of acute renal failure. Recent studies, however have tended to blurr these clinical distinctions. Many adult patients with "TT.R "lack one or more of the five criteria and patients with "HUS" have fever and neurological dysfunction. Hemolvtic uremic syndrome Hemolytic uremic syndrome is characterized by the triad of : Anemia (microangiopathic hemolytic anemia). Renal failure (microangiopathy of kidney involving glomerular capillaries and aerioles). Thrombocytopenia (due to platelet consumption). Hemolytic uremic syndrome is most common is children under 2 years of age. It usually follows an episode of acute gastroenterities, often triggered by E coli. The prodrome is usually of abdominal pain, diarrhoea and vomiting. Sholy thereafter, signs and symptoms of acute hemolytic anemia, thrombocytopenia and acute renal failure ensue. Sometimes neurological findings also occur. (But usually absent and differentiate HUS from TTP.) Rarely HUS may follow respiratory tract infection. Etiology Gastrointestinal infection in infants with the following organism : E coli, Shigella dysenteriae, Streptococouus pneumoniae Hematological findings in a case of microangiopathic hemolytic anemia : Presence of schistocytes (fragmented red cells). This is the hallmark of microangiopathic hemolytic anemia. Neutrophil leukocytosis. Thrombocytopenia. Hemoglobinuria is mild to moderate with hemosiderinuria. Blood urea and serum creatinine levels are high. PT and APTT normal. Elevated serum LDH
Hyperkalemia
Anaemia
Renal microthrombi
Neuro psychiatric disturbances