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<p><span style="color: #000000"><b>Hemolytic-uremic syndrome</b> (or <b>haemolytic-uraemic syndrome</b>), abbreviated <b>HUS</b>, is a disease characterized by hemolytic anemia, acute renal failure (uremia) and a low platelet count (thrombocytopenia). It predominantly but not exclusively affects children. Most cases are preceded by an episode of diarrhea caused by <i>E. coli</i> O157:H7, which is acquired as a foodborne illness. It is a medical emergency and carries a 5–10% mortality; of the remainder, the majority recover without major consequences but a small proportion develop chronic kidney disease and become reliant on renal replacement therapy.<sup id="cite_ref-pmid11691946_0-0" class="reference"><font size="2">[1]</font></sup> HUS was first defined as a syndrome in 1955.<sup id="cite_ref-pmid1816053_1-0" class="reference"><font size="2">[2]</font></sup><sup id="cite_ref-pmid13274004_2-0" class="reference"><font size="2">[3]</font></sup></span></p>
<p><table id="toc" class="toc"> <tbody> <tr> <td> <div id="toctitle"> <h2> </h2> </div> </td> </tr> </tbody></table></p>
<h2><span style="color: #000000"><span id="Signs_and_symptoms" class="mw-headline">Signs and symptoms</span></span></h2>
<h3><span style="color: #000000"><span id="In_children" class="mw-headline">In children</span></span></h3>
<p><span style="color: #000000">In the classical form (90% of cases), the STEC toxin enters the bloodstream and causes damage to the body's vascular endothelium. This is especially damaging to the kidney, where the toxin attaches to the glomerular endothelium and initiates a noninflammatory reaction leading to acute renal failure. Moreover, the generalized endothelial damage leads to platelet activation that causes thrombocytopenia (low platelet count). The renal glomerular endothelial cells express a receptor for the toxin. <sup id="cite_ref-5" class="reference"><font size="2">[6]</font></sup></span></p>
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<div style="width: 222px" class="thumbinner"><span style="color: #000000"><font size="2"><img class="thumbimage" alt="" width="220" height="182" src="http://upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Shiga_toxin_type_2_%28Stx2%29_from_from_Escherichia_coli_O157-H7_PDB_1r4p.png/220px-Shiga_toxin_type_2_%28Stx2%29_from_from_Escherichia_coli_O157-H7_PDB_1r4p.png" width="220" height="182" /></font></span>
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<div class="magnify"><span style="color: #000000"><font size="2"><img alt="" width="15" height="11" src="http://bits.wikimedia.org/skins-1.17/common/images/magnify-clip.png" width="15" height="11" /></font></span></div>
<span style="color: #000000">Shiga-like toxin 2 (Stx2) from <i>Escherichia coli</i> O157:H7. From PDB 1R4P.</span></div>
</div>
<div style="list-style-type: decimal; -moz-column-count: 2; -webkit-column-count: 2; column-count: 2" class="reflist references-column-count references-column-count-2">
<ol class="references">
<li id="cite_note-pmid11691946-0">^ <a href="http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome#cite_ref-pmid11691946_0-0"><sup><i><b><font color="#0645ad" size="1">a</font></b></i></sup></a> <a href="http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome#cite_ref-pmid11691946_0-1"><sup><i><b><font color="#0645ad" size="1">b</font></b></i></sup></a> <span class="citation Journal">Corrigan JJ, Boineau FG (November 2001). "Hemolytic-uremic syndrome". <i>Pediatr Rev</i> <b>22</b> (11): 365–9. <a class="mw-redirect" title="PubMed Identifier" href="http://en.wikipedia.org/wiki/PubMed_Identifier"><font color="#0645ad">PMID</font></a> <a class="external text" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/11691946" rel="nofollow"><font color="#3366bb">11691946</font></a>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Hemolytic-uremic+syndrome&rft.jtitle=Pediatr+Rev&rft.aulast=Corrigan+JJ%2C+Boineau+FG&rft.au=Corrigan+JJ%2C+Boineau+FG&rft.date=November+2001&rft.volume=22&rft.issue=11&rft.pages=365%E2%80%939&rft_id=info:pmid/11691946&rfr_id=info:sid/en.wikipedia.org:Hemolytic-uremic_syndrome"><span style="display: none"> </span></span></li> <li id="cite_note-pmid1816053-1"><b><a href="http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome#cite_ref-pmid1816053_1-0"><font color="#0645ad">^</font></a></b> <span class="citation Journal">Anagnou NP, Papanicolaou N, Fessas P (1991). "Recurrent attacks of hemolytic uremic syndrome". <i>Haematologia (Budap)</i> <b>24</b> (2): 101–5. <a class="mw-redirect" title="PubMed Identifier" href="http://en.wikipedia.org/wiki/PubMed_Identifier"><font color="#0645ad">PMID</font></a> <a class="external text" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/1816053" rel="nofollow"><font color="#3366bb">1816053</font></a>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Recurrent+attacks+of+hemolytic+uremic+syndrome&rft.jtitle=Haematologia+%28Budap%29&rft.aulast=Anagnou+NP%2C+Papanicolaou+N%2C+Fessas+P&rft.au=Anagnou+NP%2C+Papanicolaou+N%2C+Fessas+P&rft.date=1991&rft.volume=24&rft.issue=2&rft.pages=101%E2%80%935&rft_id=info:pmid/1816053&rfr_id=info:sid/en.wikipedia.org:Hemolytic-uremic_syndrome"><span style="display: none"> </span></span></li> <li id="cite_note-pmid13274004-2"><b><a href="http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome#cite_ref-pmid13274004_2-0"><font color="#0645ad">^</font></a></b> <span class="citation Journal">GAsser C, Gautier E, Steck A, Siebenmann RE, Oechslin R (September 1955). "Hemolytic-uremic syndrome: bilateral necrosis of the renal cortex in acute acquired hemolytic anemia" (in German). <i>Schweiz Med Wochenschr</i> <b>85</b> (38-39): 905–9. <a class="mw-redirect" title="PubMed Identifier" href="http://en.wikipedia.org/wiki/PubMed_Identifier"><font color="#0645ad">PMID</font></a> <a class="external text" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/13274004" rel="nofollow"><font color="#3366bb">13274004</font></a>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Hemolytic-uremic+syndrome%3A++bilateral+necrosis+of+the+renal+cortex+in+acute+acquired+hemolytic+anemia&rft.jtitle=Schweiz+Med+Wochenschr&rft.aulast=GAsser+C%2C+Gautier+E%2C+Steck+A%2C+Siebenmann+RE%2C+Oechslin+R&rft.au=GAsser+C%2C+Gautier+E%2C+Steck+A%2C+Siebenmann+RE%2C+Oechslin+R&rft.date=September+1955&rft.volume=85&rft.issue=38-39&rft.pages=905%E2%80%939&rft_id=info:pmid/13274004&rfr_id=info:sid/en.wikipedia.org:Hemolytic-uremic_syndrome"><span style="display: none"> </span></span></li>
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Ther.</i> <b>24</b> (5): 731–42. <a title="Digital object identifier" href="http://en.wikipedia.org/wiki/Digital_object_identifier"><font color="#0645ad">doi</font></a>:<a class="external text" rel="nofollow" href="http://dx.doi.org/10.1111%2Fj.1365-2036.2006.03036.x" rel="nofollow"><font color="#3366bb">10.1111/j.1365-2036.2006.03036.x</font></a>. <a class="mw-redirect" title="PubMed Identifier" href="http://en.wikipedia.org/wiki/PubMed_Identifier"><font color="#0645ad">PMID</font></a> <a class="external text" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/16918877" rel="nofollow"><font color="#3366bb">16918877</font></a><span class="printonly">. <a class="external free" rel="nofollow" href="http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2006&volume=24&issue=5&spage=731" rel="nofollow"><font color="#3366bb">http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2006&volume=24&issue=5&spage=731</font></a></span>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Systematic+review%3A+are+antibiotics+detrimental+or+beneficial+for+the+treatment+of+patients+with+Escherichia+coli+O157%3AH7+infection%3F&rft.jtitle=Aliment.+Pharmacol.+Ther.&rft.aulast=Panos+GZ%2C+Betsi+GI%2C+Falagas+ME&rft.au=Panos+GZ%2C+Betsi+GI%2C+Falagas+ME&rft.date=September+2006&rft.volume=24&rft.issue=5&rft.pages=731%E2%80%9342&rft_id=info:doi/10.1111%2Fj.1365-2036.2006.03036.x&rft_id=info:pmid/16918877&rft_id=http%3A%2F%2Fwww.blackwell-synergy.com%2Fopenurl%3Fgenre%3Darticle%26sid%3Dnlm%3Apubmed%26issn%3D0269-2813%26date%3D2006%26volume%3D24%26issue%3D5%26spage%3D731&rfr_id=info:sid/en.wikipedia.org:Hemolytic-uremic_syndrome"><span style="display: none"> </span></span></li>
<li id="cite_note-12"><b><a href="http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome#cite_ref-12"><font color="#0645ad">^</font></a></b> <span class="citation book">Chu P, Hemphill RR (2004). "222: Acuired hemolytic anemia". In Tintinalli JE, Kelen GD, Stapczynski JS. <i>Emergency Medicine: A Comprehensive Study Guide</i> (6th ed.). New York, NY: McGraw-Hill. <a title="International Standard Book Number" href="http://en.wikipedia.org/wiki/International_Standard_Book_Number"><font color="#0645ad">ISBN</font></a> <a title="Special:BookSources/0-07-138875-3" href="http://en.wikipedia.org/wiki/Special:BookSources/0-07-138875-3"><font color="#0645ad">0-07-138875-3</font></a>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.btitle=222%3A+Acuired+hemolytic+anemia&rft.atitle=Emergency+Medicine%3A+A+Comprehensive+Study+Guide&rft.aulast=Chu+P%2C+Hemphill+RR&rft.au=Chu+P%2C+Hemphill+RR&rft.date=2004&rft.edition=6th&rft.place=New+York%2C+NY&rft.pub=McGraw-Hill&rft.isbn=0-07-138875-3&rfr_id=info:sid/en.wikipedia.org:Hemolytic-uremic_syndrome"><span style="display: none"> </span></span></li>
<li id="cite_note-13"><b><a href="http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome#cite_ref-13"><font color="#0645ad">^</font></a></b> <span class="citation news"><a class="external text" rel="nofollow" href="http://www.guardian.co.uk/world/2011/jun/02/e-coli-outbreak-uk-cases" rel="nofollow"><font color="#3366bb">"E coli outbreak: three UK cases have rare strain"</font></a>. <i>The Guardian</i>. 2 June 2011<span class="printonly">. <a class="external free" rel="nofollow" href="http://www.guardian.co.uk/world/2011/jun/02/e-coli-outbreak-uk-cases" rel="nofollow"><font color="#3366bb">http://www.guardian.co.uk/world/2011/jun/02/e-coli-outbreak-uk-cases</font></a></span>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=E+coli+outbreak%3A+three+UK+cases+have+rare+strain&rft.jtitle=The+Guardian&rft.date=2+June+2011&rft_id=http%3A%2F%2Fwww.guardian.co.uk%2Fworld%2F2011%2Fjun%2F02%2Fe-coli-outbreak-uk-cases&rfr_id=info:sid/en.wikipedia.org:Hemolytic-uremic_syndrome"><span style="display: none"> </span></span></li>
</ol>
</div>
<h2><span id="External_links" class="mw-headline">External links</span></h2>
<ul>
<li><a class="external text" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/books/NBK1367/" rel="nofollow"><font color="#3366bb">GeneReviews/NCBI/NIH/UW entry on Atypical hemolytic-uremic syndrome</font></a></li>
</ul>
