Haemolytic uraemic syndrome

This complication of food poisoning occurs following an e coli infection (e coli 0157:H7) but tends to be rare. It is more common in children and is the main cause of kidney failure in children.

Most people recover from this without any ill effects but a small percentage develop kidney failure and require either dialysis or a transplant.

Children and teenagers are susceptible to this disease as well as adults and the elderly.

Causes of haemolytic uraemic syndrome

This occurs following a bout of e coli food poisoning, in particular that caused by the 0157:H7 strain. This strain of bacteria is particularly virulent and develops as a result of eating contaminated foods such as undercooked meat or unpasteurised milk.

This strain of bacteria releases a toxin called ‘verotoxin’which spreads to the kidneys, resulting in the formation of blood clots within tiny blood vessels in the kidneys.

This leads to kidney damage (haemolytic uraemic syndrome) and eventual failure.

This syndrome is comprised of three conditions:

  • Haemolytic anaemia (a low red blood cell count)
  • Thrombocytopenia (low platelet count)
  • Renal failure (kidney failure)

People who have been given antibiotics or some other form of medication to treat e coli poisoning are at increased risk of developing haemolytic uraemic syndrome.

Why are children at increased risk of haemolytic uraemic syndrome?

This may be due to an underdeveloped immune system which is less efficient than an adult’s at fighting off disease or infection. It is particularly prevalent in children under 5.

Symptoms of haemolytic uraemic syndrome

These start with vomiting and diarrhoea which may contain blood. Other early stage symptoms include:

  • Fever
  • Fatigue
  • Weakness
  • Irritability

The first week of this disease is characterised by extreme tiredness, feeling weak and shaky and irritability. If you develop these symptoms then you will also find that you urinate far less than normal which causes a reduction in your urine output.

These symptoms appear at a later stage:

  • Jaundice (yellowing of the skin)
  • Skin rash
  • Bruising on the skin
  • Pale appearance
  • Breathlessness (and other signs of anaemia)

These symptoms occur as a result of the destruction of red blood cells by toxins, such as those produced during a bout of food poisoning.

Diagnosing haemolytic uraemic syndrome

You will undergo a series of tests to confirm or reject this diagnosis. These include blood and urine tests plus a stool sample. You may also undergo a kidney biopsy.

A kidney biopsy is a procedure in which a small sample of tissue is removed from your kidneys under anaesthetic. This sample is then sent to a laboratory for analysis and to determine the extent of any kidney damage.

Treatment for haemolytic uraemic syndrome

This involves medication such as corticosteroids and blood transfusions. A blood transfusion will boost your red blood cell and platelet count, and may be augmented by a plasma infusion as well.

Serious cases will require kidney dialysis.

Children are more likely to be affected by this disease than adults but they have a better outcome. This disease is fatal if left untreated but most people respond well to treatment.

Are there complications?

Yes. This disease can lead to blood clotting problems, nervous system disorders and kidney failure. If this occurs then they will require dialysis on a permanent basis or a kidney transplant.

Food Poisoning Guide

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