Is vomiting blood serious? Let's learn about Hemolytic Uremic Syndrome (HUS)!

Has your little one been having diarrhea for a few days? Every mother and father would be scared if they saw a little blood in their stool? Most of the time, it is thought to be a simple stomach ache, but sometimes it can be the first sign of a more serious condition. That is what we are talking about today, Hemolytic Uremic Syndrome, or HUS for short, a serious condition that can occur, especially after an infection with the bacteria E. coli. Let's learn about this simply and precisely.

Simply put, what is HUS?

Think of the blood vessels throughout our bodies as a network of roads. These roads are where our red blood cells carry oxygen throughout the body. In a condition called HUS, blood clots form and become blocked in the tiny blood vessels (capillaries), especially in the kidneys . It's like a water pipe getting clogged with dirt and water.

When blood vessels become blocked in this way, three main things happen:

1. Hemolytic Anemia: Red blood cells that try to pass through blocked blood vessels get stuck, get crushed, and break. This causes a decrease in blood volume in the body, which means anemia.

2. Decreased platelet count (Thrombocytopenia): These small cells that help blood clot are used up in the blood clots that form inside the blood vessels. As a result, the normal number of platelets in the blood decreases.

3. Kidney Failure: Because the kidneys do not receive enough blood supply and the blood vessels are damaged, the kidneys are unable to properly filter waste products from our bodies and excrete them as urine. This can lead to sudden kidney failure.

What is the main cause of HUS?

Most of the time, about 90% of the time, HUS is caused by a bacterium called E. coli (Escherichia coli), which produces a toxin called Shiga toxin . This bacterium enters our bodies through dirty, undercooked food or contaminated water.

Imagine this scenario. You are eating at a restaurant with your family. If you eat undercooked beef (especially ground beef), unpasteurized milk or cheese, or unwashed lettuce or vegetables, it could contain E. coli bacteria.

When this bacteria enters the body, it causes watery diarrhea with stomach pain within a few days. This can turn into bloody diarrhea within a day or two. The Shiga toxin produced by the bacteria damages the walls of our intestines and causes bleeding. This toxin then travels throughout the body, damaging the small blood vessels in the kidneys. This is how HUS begins.

Are there main types of HUS?

Yes, HUS can be divided into several main types.

• "Typical" HUS: This is the type we've been talking about so far, most commonly caused by a bacterial infection like E. coli.
• Atypical HUS (aHUS): This is a rarer type. It is caused by a genetic defect. This means that it can be inherited from parents to children. These people can develop HUS suddenly, even if they have something like a common cold or flu.
• Secondary HUS: This occurs as a side effect of another medical condition (e.g. cancer) or certain medications (e.g. anti-cancer drugs, immunosuppressants).

What are the symptoms of HUS? How is it diagnosed?

Symptoms of HUS usually appear in two stages. First, symptoms related to the intestinal infection appear. Then, the more serious symptoms related to HUS appear.

When should you see a doctor immediately?

If you or your child has these symptoms, you should go to a hospital's Emergency Department (ETU) without delay .

• Diarrhea that lasts more than three days.
• Diarrhea with blood.
• If the amount of urine you pass decreases significantly.
• If the child is pale and overly tired.
• If the body is swollen.

How do doctors confirm HUS status?

The doctor who examines you will listen carefully to your symptoms and then order several tests to confirm the diagnosis of HUS.

• Blood Tests: These can check for low red blood cell and platelet counts, and kidney function (creatinine, urea, etc.).
• Urinalysis: Checks for blood or protein in the urine.
• Stool Test: Checks for bacteria like E. coli O157 in stool.
• Kidney Biopsy: Sometimes, a very small piece of the kidney may need to be taken and tested to confirm the diagnosis.

What are the treatments for HUS?

HUS is a condition that requires hospitalization . It cannot be treated at home. These are the main treatments given in the hospital.

1. Give saline and nutrition: Diarrhea and vomiting can cause dehydration by removing water and salts from the body. To prevent this, saline (IV fluids) are given through a vein. If you are unable to eat, nutrition is given through a tube.

2. Blood and platelet transfusions: Blood is given if the red blood cell count is too low (anemia). Platelets are also given if the platelet count is too low and there is a risk of bleeding.

3. Dialysis: If the kidneys are too weak to remove waste products from the body, dialysis, a machine that cleans the blood, is necessary. This is often a temporary procedure. Dialysis can be stopped when the kidneys start working again.

4. Specialized drugs: For rare types like atypical HUS (aHUS), specialized drugs like eculizumab or ravulizumab are used.

What should we do to avoid HUS?

The best way to prevent HUS is to take care of the little things in our daily lives.

• Be sure to wash your hands thoroughly with soap before preparing food and after using the toilet.
• Cook meat, fish, and eggs well. Cook ground meat, especially until it is well cooked inside.
• Wash raw vegetables, fruits, and lettuce thoroughly with clean water.
• Avoid drinking unpasteurized/raw milk, dairy products, and fruit drinks.
• Do not use cutting boards, knives, or other items used for raw meat or fish for cooked food. Wash and clean them thoroughly after use.
• Avoid swimming in dirty reservoirs, rivers, and streams.
• If you have diarrhea, avoid going to swimming pools.

HUS is a scary condition. But if diagnosed early, treated and treated promptly, more than 85% of people recover completely . The damage to the kidneys is often temporary. So the most important thing is to be aware of the symptoms and seek medical advice as soon as possible.

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