SAQ 260 – Paediatrics – haemolytic uraemic syndrome

Question 4. haemolytic uraemic syndrome.

a. Differential diagnoses

• Infectious gastroenteritis.
• Cow's-milk or soy-protein-induced colitis.
• Meckel diverticulitis.
• Intussusception.
• IgA vasculitis.
• Iron ingestion.
• Volvulus.
• Haemophilia.
• Inflammatory bowel disease.

b. Examination findings

• Pallor.
• Haematuria.
• Hypertension.
• Encephalopathy or seizures.
• Hepatosplenomegaly.
• Peritoneal signs or ileus.
• Associated pneumococcal disease.

c. Laboratory findings

• Acute kidney injury with elevated urea and creatinine.
• Anaemia with reticulocytosis and low haptoglobin.
• Fragmented red cells on blood film.
• Thrombocytopenia.
• Haematuria, proteinuria, dysmorphic red cells, or casts.
• Raised bilirubin or LDH.
• Elevated fibrin-degradation products with normal PT and APTT.