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4 out of 7

All of the following statements are true about HUS except: (LQ)

A Uraemia

B Hypofibrinogenemia

C Thrombocytopenia

D Positive coomb's test

Ans. D Positive coomb's test

HUS is characterized by (AIIMS May 07)

1. Microangiopathichemolytic anaemia(MAHA): (intravascular haemolysis + red cell fragmentation).

2. ARF

3. Thrombocytopenia

4. Fever

Extra Edge: CNS involvement is not a feature of HUS.

Extra Edge:

a. Cause 90% due to E coli 0157: produces a verotoxin which attacks endothelial cells.

b. This affects young children most, often occurring in outbreaks due to consumption of undercooked contaminated meat, with abdominal pain, bloody diarrhea and ARF.


I. Endothelial damage triggers thrombosis, platelet consumption and fibrin deposition, mainly in the renal microvasculature.

II. The strands cause mechanical destruction of passing red blood cells.

III. Thrombocytopenia and ARF occur.


Blood film:fragmented RBC platelets, Hb is reduced but Clotting tests are normal. There may be haematuria, proteinuria. Often resolves spontaneously.

Extra Edge:

1. Fibrinogen level, and assays for fibrin degradation products such as "D-Dimers", are generally normal despite the low platelet count (thrombocytopenia)

2. Coombs test is negative.

Treatment: No specific treatment, dialysis for ARF

Prognosis:Worse in non- E. Coli cases. Mortality 3-5%.