Snapshot A 7-year-old boy recently had several episodes of bloody diarrhea. Desperate, his parents called his primary care physician, who reassured them that the infection is self-limited. Still concerned, his parents bought some diarrhea pills (anti-motility agents). A week later, he presents to the ER with jaundice, abdominal pain, and easy bruising. Lab results come back with low platelet count, anemia, and increased creatinine. A peripheral blood shows schistocytes. He is started on IV hydration. Introduction Syndrome commonly seen in children login to view 6 more bullets Classic triad login to view 3 more bullets Similar to TTP but without fever and neurologic symptoms Epidemiology Most commonly in children Exposed to E. coli login to view 3 more bullets Risk factors login to view 2 more bullets ETIOLOGY Pathogenesis login to view 5 more bullets Presentation Symptoms login to view 7 more bullets Physical exam login to view 4 more bullets STUDIES Criteria for HUS login to view 5 more bullets Normal PT/PTT Negative Coombs test ↑ bleeding time Differential Characteristics DIC ITP TTP HUS Fever No No Yes Yes/No Splenomegaly No No Yes Yes Platelets Low Low Low Low Bleeding time ↑ ↑ ↑ ↑ PT ↑ PTT ↑ Shistocytes Yes No Yes Yes Trauma Yes No No No Treatment Prevention login to view 3 more bullets Supportive care with fluids to maintain renal perfusion login to view 1 more bullet Fresh frozen plasma can be used (increases coagulation factor levels) Plasmapheresis or plasma exchange for severe cases Complications Chronic kidney disease Hypertension Heart failure Electrolyte abnormalities Prognosis 3-5% mortality 5% severe sequelae such as end-stage renal failure