Hemolytic uremic syndrome (HUS)

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Causes

By Mayo Clinic staff

A number of things can cause hemolytic uremic syndrome, but the most common cause — particularly in children — is an infection with a specific strain of E. coli, usually the strain known as O157:H7.

E. coli refers to a group of bacteria normally found in the intestines of healthy humans and animals. Of the hundreds of types of E. coli, most are harmless. But some strains of E. coli are responsible for serious foodborne infections, including those that can lead to hemolytic uremic syndrome. E. coli may be found in:

  • Contaminated meat or produce
  • Swimming pools or lakes contaminated with feces

Most people who are infected with E. coli, even the more dangerous strains, won't develop hemolytic uremic syndrome. It's also possible for hemolytic uremic syndrome to follow infection with other types of bacteria.

In adults, hemolytic uremic syndrome is more commonly caused by other factors, including:

  • The use of certain medications, such as quinine (an over-the-counter muscle cramp remedy), some chemotherapy drugs, the immunosuppressant medication cyclosporine (Neoral, Sandimmune), anti-platelet medications and oral contraceptives
  • Pregnancy
  • Certain infections, such as HIV/AIDS or an infection with the pneumococcal bacteria

However, the cause of hemolytic uremic syndrome in adults is often unknown.

References
  1. Hemolytic uremic syndrome in children. National Institutes of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/hemolyticuremic.pdf. Accessed Oct. 22, 2010.
  2. Piercefield EW, et al. Hemolytic uremic syndrome after an Escherichia coli O111 outbreak. Archives of Internal Medicine. 2010;170:1656.
  3. Thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec11/ch133/ch133g.html. Accessed Oct. 22, 2010.
  4. George JN. Causes of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 22, 2010.
  5. Niaudet P. Clinical manifestations and diagnosis of Shiga-like toxin associated (typical) hemolytic uremic syndrome in children. http://www.uptodate.com/home/index.html. Accessed Oct. 22, 2010.
  6. Noris M, et al. Atypical hemolytic-uremic syndrome. New England Journal of Medicine. 2009;361:1676.
  7. Foodborne illness: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/files/foodborne_illness_FAQ.pdf. Accessed Oct. 22, 2010.
  8. Elliott MM, et al. Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura (Review). Cochrane Database Systematic Reviews. 2009:CD003595.http://www2.cochrane.org/reviews. Accessed Oct. 22, 2010.
  9. Scheiring J, et al. Today's understanding of the haemolytic uraemic syndrome. European Journal of Pediatrics. 2010;169:17.
  10. Nast CC, et al. Thrombotic microangiopathies. In: Lerma EV, et al. Current Diagnosis & Treatment: Nephrology & Hypertension. New York, N.Y.: The McGraw Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=6336929. Accessed Oct. 22, 2010.
  11. Pigott DC. Foodborne illness. Emergency Medical Clinics of North America. 2008;26:475.
DS00876 Dec. 18, 2010

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