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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The most important feature in diagnosis is a high index of suspicion. Clinical features are as follows:

  • most commonly occurs following diarrhoeal illness
  • blood passed in the stool of any child with diarrhoea should alert to the diagnosis
  • there may be a mild amount of dehydration; however this is out of proportion to the degree of uraemia found in the blood
  • renal abnormalities - oliguria is common although in some cases the patient may be polyuric with proteinuria and haematuria
  • cardiovascular abnormalities:
    • if HUS is diarrhoea-associated then the patient is generally normotensive (1)
    • severe hypertension and retinopathy are associated with sporadic cases of HUS
  • CNS abnormalities - such as irritability, restlessness, drowsiness, cerebellar ataxia and coma may occur, more commonly in females
  • skin purpura - more common in TTP
  • gastrointestinal abnormalities - as well as there often being an acute diarrhoeal illness, HUS may present with perforation or infarction if the microvascular disease involves the bowel itself
  • rhabdomyolysis has been reported


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

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