Management of hemolytic uremic syndrome

Presse Med. 2012 Mar;41(3 Pt 2):e115-35. doi: 10.1016/j.lpm.2011.11.013. Epub 2012 Jan 27.

Abstract

2011 has been a special year for hemolytic uremic syndrome (HUS): on the one hand, the dramatic epidemic of Shiga toxin producing E. coli -associated HUS in Germany brought the disease to the attention of the general population, on the other hand it has been the year when eculizumab, the first complement blocker available for clinical practice, was demonstrated as the potential new standard of care for atypical HUS. Here we review the therapeutic options presently available for the various forms of hemolytic uremic syndrome and show how recent knowledge has changed the therapeutic approach and prognosis of atypical HUS.

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Algorithms
  • Amino Acid Metabolism, Inborn Errors / complications
  • Amino Acid Metabolism, Inborn Errors / diagnosis
  • Amino Acid Metabolism, Inborn Errors / therapy
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Atypical Hemolytic Uremic Syndrome
  • Blood Volume
  • Child
  • Diuretics / therapeutic use
  • Fibrinolytic Agents / therapeutic use
  • Germany / epidemiology
  • Hemolytic-Uremic Syndrome / diagnosis
  • Hemolytic-Uremic Syndrome / epidemiology
  • Hemolytic-Uremic Syndrome / etiology
  • Hemolytic-Uremic Syndrome / therapy*
  • Homocystinuria / complications
  • Homocystinuria / diagnosis
  • Homocystinuria / therapy
  • Humans
  • Kidney Transplantation
  • Plasma / immunology
  • Plasma Exchange / methods
  • Plasmapheresis
  • Pneumococcal Infections / complications
  • Prognosis
  • Renal Dialysis
  • Shiga Toxins / immunology
  • Shiga Toxins / toxicity
  • Shiga-Toxigenic Escherichia coli*
  • Streptococcus pneumoniae
  • Vitamin B 12 Deficiency / congenital
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Diuretics
  • Fibrinolytic Agents
  • Shiga Toxins
  • eculizumab

Supplementary concepts

  • Methylmalonic acidemia with homocystinuria