Hemolytic-Uremic Syndrome in Children

Pediatr Clin North Am. 2022 Dec;69(6):1181-1197. doi: 10.1016/j.pcl.2022.07.006. Epub 2022 Oct 29.


Hemolytic uremic syndrome is characterized by a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney failure. Most cases are caused by Shiga-toxin-producing bacteria, especially Escherichia coli. Transmission occurs through ground beef and unpasteurized milk. STEC-HUS is the main cause of acute renal failure in children. Management remains supportive. Immediate outcome is most often. Atypical HUS represents about 5% of cases, has a relapsing course with more than half of the patients progressing to end-stage kidney failure. Most cases are due to variants in complement regulators of the alternative pathway. Complement inhibitors, such as eculizumab, have considerably improved the prognosis.

Keywords: Alternative pathway of complement; Eculizumab; Hemolytic uremic syndrome; Shiga toxin; Thrombotic microangiopathy.

Publication types

  • Review

MeSH terms

  • Animals
  • Cattle
  • Child
  • Hemolytic-Uremic Syndrome* / diagnosis
  • Hemolytic-Uremic Syndrome* / therapy
  • Humans
  • Kidney Failure, Chronic*
  • Thrombocytopenia*