Hem/Onc: Hemolytic Uremic Syndrome

-occurs <5yo following a URI or gastroenteritis (E coli 157:h7, shigella, salmonella)
fATRn - nephropathy, microangiopathic hemolytic anemia, thrombocytopenia
-GI - 75% have pain (can have intussuseption, perf), vomiting, diarrhea (may be bloody)
-Renal - dec uop (gross hemat rare)
-skin - pallor, petechiae, purpura
-Hypertn in 50%
-CNS - sz, coma, encephalopathy

Lab:
-u/a - hematuria, proteinuria, casts
-CBC - low Hb, low PLT, low WBC
-smear - schistocytes, helmet cells
-low Na & CO2, high K, BUN & Cr
-coags nl

Rx:
-dialysis - CHF, BUN>100, encephalopathy, anuria>24hrs or hyperkalemia
-anti-HTNs
-PRBCs - if hb<8
-plasma exchange - cns or severe renal involvement
-plasmapheresis - as above
-DO NOT give platelets - can worsen organ damage