A 8 yr old boy presents with petechie, azotemic oligurea altered sensorium in casualty. There is history of diarrhoea for the past 5 days. The clinical diagnosis is -
Acute prophyria
Idiopathic thrombocytopenic purpura
H.S. purpura
H.U.S.
Ans. is 'a' i.e., Hemolytic uremic syndrome The boys is suffering from hemolytic uremic syndrome. Hemolytic uremic syndrome HUS is characterized by the triad of - 1) Anemia (microangiopathic hemolytic anemia) 2) Renal failure (microangiopathy of kidney involving glomerular capillaries and aerioles). 3) Thrombocytopenia (due to platelet destruction) o HUS is common in children under 2 years of age. (But may also occur in older children). o It usually follows an episode of acute gastroenteritis. o The prodrome is usually of abdominal pain, diarrhoea and vomiting. Sholy thereafter, signs and symptoms of acute hemolytic anemia, thrombocytopenia and acute renal failure ensue. o Sometimes neurological findings also occur (But usually absent and differentiates HUS from TTP).