Hemolytic-uremic syndrome is best described by which statement?

Hemolytic-uremic syndrome is best described by which statement?

• A. It is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute nephropathy.
• B. It is primarily a liver disease with coagulopathy.
• C. It is caused by viral infection exclusively.
• D. It never affects children.

Answer: (A)

Hemolytic-uremic syndrome is defined by a microangiopathic process that creates a triad: microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury due to widespread microvascular thrombosis, especially in the kidneys. The damaged red cells fragment as they traverse these narrowed vessels, leading to schistocytes on a blood smear and elevated markers of hemolysis. Platelets are consumed in forming the microthrombi, causing low platelet counts. Kidney injury results from endothelial damage and reduced renal perfusion from those same microthrombi. This pattern is the hallmark, and it often follows a diarrheal illness with Shiga-toxin–producing bacteria, particularly in children. The other statements don’t fit: it’s not a primary liver disease with coagulopathy; it’s not caused exclusively by a viral infection; and it can—and commonly does—affect children.

Hemolytic-uremic syndrome is defined by a microangiopathic process that creates a triad: microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury due to widespread microvascular thrombosis, especially in the kidneys. The damaged red cells fragment as they traverse these narrowed vessels, leading to schistocytes on a blood smear and elevated markers of hemolysis. Platelets are consumed in forming the microthrombi, causing low platelet counts. Kidney injury results from endothelial damage and reduced renal perfusion from those same microthrombi. This pattern is the hallmark, and it often follows a diarrheal illness with Shiga-toxin–producing bacteria, particularly in children. The other statements don’t fit: it’s not a primary liver disease with coagulopathy; it’s not caused exclusively by a viral infection; and it can—and commonly does—affect children.