Pathology

Most cases of haemolytic uraemic syndrome are associated with diarrhoea and occur in children. These cases, in general, have a natural history where there is complete recovery and there is usually no renal biopsy taken.

Diarrhoea-associated HUS characterised by:

• glomerular capillary thrombosis
• some arteriolar thrombosis and necrosis

Idiopathic HUS:

• generally occurs in adults
• show a preglomerular pathology with intimal proliferation and luminal stenosis affecting arterioles and small arteries
• in 10% of adult cases there are no pathological changes seen in the glomeruli or vessels and the only lesion seen is acute tubular necrosis (1)

Reference:

• (1) Neild GH (1993). Haemolytic uraemic syndrome in practice. Lancet, 343, 398-402.