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Hematology Thrombotic Microangiopathies Intermediate
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Hemolytic Uremic Syndrome Triad

ART
OF
HUS
The pathognomonic clinical triad of Shiga toxin-mediated thrombotic microangiopathy in pediatric patients.

Enterohemorrhagic E. coli (EHEC O157:H7) produces Shiga-like toxin that injures glomerular endothelial cells, triggering platelet microthrombi and microangiopathic hemolytic anemia.

Systematic Breakdown

A

Anemia (Microangiopathic Hemolytic Anemia)

Coombs-negative hemolytic anemia with abundant schistocytes (helmet cells) on peripheral blood smear.

R

Renal Failure (Acute Oliguria / Anuria)

Glomerular capillary microthrombi severely impair filtration, causing hematuria, proteinuria, and azotemia.

T

Thrombocytopenia

Platelet consumption within microvascular thrombi leading to low platelet counts without DIC (normal PT and aPTT).

High-Yield Clinical Pearls & Exam Tips
  • Do NOT give antibiotics for EHEC O157:H7 bloody diarrhea! Antibiotics trigger bacterial lysis, increasing Shiga toxin release and worsening HUS risk.
  • Normal coagulation parameters (PT, aPTT, Fibrinogen) differentiate HUS from Disseminated Intravascular Coagulation (DIC).
Related Pharmaceuticals
Eculizumab (for atypical HUS)
Related Clinical Conditions
EHEC Infection Thrombotic Thrombocytopenic Purpura (TTP) Acute Kidney Injury
Authoritative Sources: Pediatric Nephrology 7e · First Aid USMLE Step 1

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