HUS Seminar

ARF in India ,[object Object],[object Object],[object Object],[object Object],[object Object]

Conventional Classification ,[object Object],[object Object]

Kidney International (2006) 70, 423–431.

Unclassified S. pneumoniae Complement disorders ADAMTS defect Familial, unexplained Diarrhea, VTEC infection HUS: 95% cases Kidney International (2006) 70: 423–431

HUS in India ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

How did these otherwise harmless E. coli become such killers? ,[object Object],[object Object]

Pathophysiology; from diarrhea to dialysis ,[object Object],[object Object],[object Object],Andreoli SP: The Pathophysiology of the hemolytic uremic syndrome , Curr Opin Nephrol Hypertens 8:459-64,1999

Pathophysiology; from diarrhea to dialysis contd… ,[object Object],[object Object],Andreoli SP: The Pathophysiology of the hemolytic uremic syndrome , Curr Opin Nephrol Hypertens 8:459-64,1999

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Comprehensive Pediatric Nephrology by Warady & Schafer F; Ist Edition, 2008

Pathophysiology; from diarrhea to dialysis contd… ,[object Object],[object Object],[object Object],Andreoli SP: The Pathophysiology of the hemolytic uremic syndrome , Curr Opin Nephrol Hypertens 8:459-64,1999

Pathophysiology; ,[object Object],[object Object]

Pathophysiology; ,[object Object],[object Object],[object Object],[object Object],[object Object]

PATHOPHYSIOLIOGY aHUS ,[object Object],[object Object],[object Object],[object Object],Cochran, JB, 2004, Pediatr Nephrol 19:317-321.

Clinical ,[object Object],[object Object],[object Object],[object Object],Comprehensive Pediatric Nephrology by Warady & Schafer F; Ist Edition, 2008

Clinical ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratory Studies ,[object Object],[object Object],[object Object],[object Object],[object Object]

Peripheral blood smear showing many schistocytes and RBC fragments due to hemolysis, and thrombocytopenia.

Laboratory Studies contd... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Remuzzi G, Ruggeneti P. The hemolytic uremic syndrome. Kidney Int 1995; 47: 2-19

Laboratory Studies contd... ,[object Object],[object Object],[object Object],[object Object],Remuzzi G, Ruggeneti P. The hemolytic uremic syndrome. Kidney Int 1995; 47: 2-19

Laboratory Studies contd... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratory Studies contd... ,[object Object],[object Object],[object Object],[object Object],[object Object]

Glomerular TMA FIBRIN deposits in subendothelial space and in capillaries

Cortical Necrosis ,[object Object]

Hospital course and Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],Siegler R, Oakes R: Hemolytic uremic syndrome pathogenesis, treatment and outcome, Curr Opin Pediatr 17:200-04,2005

Even D+ HUS is not benign! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Siegler R, Oakes R: Hemolytic uremic syndrome pathogenesis, treatment and outcome, Curr Opin Pediatr 17:200-04,2005

Hospital course and Treatment contd… ,[object Object],[object Object],[object Object],[object Object],[object Object],Comprehensive Pediatric Nephrology by Warady & Schafer F; Ist Edition, 2008

Hospital course and Treatment contd… ,[object Object],[object Object],[object Object],[object Object]

Hospital course and Treatment contd… ,[object Object],[object Object],[object Object],[object Object],[object Object]

Hospital course and Treatment contd… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Licht et al. Am J Kidney Dis 2005;45:415-16

Hospital course and Treatment contd… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Transplantation in Atypical HUS ,[object Object],[object Object],[object Object],[object Object]

Transplant Decisions CFH or CFI Mutation* ,[object Object],[object Object],[object Object],Renal Tx * Plasma exchange before and chronically after Combined Liver-Kidney Tx Pre-operative Plasma exchange Loirat, C et al. Pediatric Transplantation 2008, Saland,et al. JASN 2009

Hospital course and Treatment contd… ,[object Object],[object Object],[object Object]

Follow-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Spizzirri FD et al. Pediatr Nephrol 11:156-60,1997

Deterrence/Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Siegler R, Oakes R: Hemolytic uremic syndrome pathogenesis, treatment and outcome, Curr Opin Pediatr 17:200-04,2005

Deterrence/Prevention ,[object Object],[object Object],[object Object],[object Object],Siegler R, Oakes R: Hemolytic uremic syndrome pathogenesis, treatment and outcome, Curr Opin Pediatr 17:200-04,2005

Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gagnadoux MF et al. Long term outcome of childhood hemolytic uremic syndrome, Clin Nephrol 46:39-49,1996

Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gagnadoux MF et al. Long term outcome of childhood hemolytic uremic syndrome, Clin Nephrol 46:39-49,1996

Outcome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Outcome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Garg AX, Suri RS, Barrowman et al. Long term renal prognosis of diarrhoea asso HUS, JAMA 290:1360-70,2003

Prognosis ,[object Object],[object Object],[object Object],[object Object]

Prevention- Can Antibiotics help? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Education ,[object Object],[object Object],[object Object],[object Object]

What is new in D+HUS ,[object Object],[object Object],[object Object],[object Object],[object Object]

What is new in D-HUS ,[object Object],[object Object],[object Object],[object Object],[object Object]

HUS Seminar

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