Hemolytic-uremic syndrome medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Specific treatment includes control of hypertension and seizures
Overview
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
OR
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
OR
The majority of cases of [disease name] are self-limited and require only supportive care.
OR
[Disease name] is a medical emergency and requires prompt treatment.
OR
The mainstay of treatment for [disease name] is [therapy].
OR The optimal therapy for [malignancy name] depends on the stage at diagnosis.
OR
[Therapy] is recommended among all patients who develop [disease name].
OR
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
OR
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
OR
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
OR
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
Medical Therapy
- The mainstay of therapy for HUS is supportive therapy and is self-limited[1] .Antibiotic therapy is not recommended among patients with HUS hawevre there are some antibiotics that decrease risk of HUS sach as quinolones. Heparin, anti-platelet agents, immunoadsorption, thrombomodulin (rhTM).Fosfomycin should be started within 48-72 hours of the patient's presentation of HUS . Empiric antibiotic therapy such as and cephalosporins for invasive pneumococcal disease should be used fallowing culture results. Recombinant human soluble thrombomodulin (rTM) is a novel medicine taht use to traet children with HUS[2].[3][4][5][6][7][8][9][10][11][2][12][13]
HUS
- Acute kidney injury
- First stop medicines that are renal toxicity[14].fluid replacement is the mainstay of treatmen[15]. Majority of patients have normokalemia[16].Hydration and intravenous (IV) isotonic saline replacment decrease risk of hemolytic-uremic syndrome (HUS)[17] and prevent of further complications . Monitor hydration and electrolytes during infection by ample fluid therapy effects on short- and long-term disease outcomes[18]
-
- Anemia
- when hemoglobin (Hgb) or hematocrit respectively became less than 6 ,18 recommend to transfuse packed red blood cells (RBC)[19]
- Anemia
.
- 2.2.1 Adult
- Parenteral regimen
- Oral regimen
- Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
- Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
- Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
- Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
- Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
- Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
- 2.2.2 Pediatric
- Parenteral regimen
- Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
- Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
- Alternative regimen (2): drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
- Oral regimen
- Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
- Preferred regimen (2): drug name 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
- Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
- Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
- Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
- Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
- Parenteral regimen
- 2.2.1 Adult
References
- ↑ Silviu Grisaru (2014). "Management of hemolytic-uremic syndrome in children". International journal of nephrology and renovascular disease. 7: 231–239. doi:10.2147/IJNRD.S41837. PMID 24966691.
- ↑ 2.0 2.1 Takashi Honda, Shohei Ogata, Eri Mineo, Yukako Nagamori, Shinya Nakamura, Yuki Bando & Masahiro Ishii (2013). "A novel strategy for hemolytic uremic syndrome: successful treatment with thrombomodulin alpha". Pediatrics. 131 (3): e928–e933. doi:10.1542/peds.2012-1466. PMID 23382444. Unknown parameter
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ignored (help) - ↑ Paul N. Goldwater & Karl A. Bettelheim (2012). "Treatment of enterohemorrhagic Escherichia coli (EHEC) infection and hemolytic uremic syndrome (HUS)". BMC medicine. 10: 12. doi:10.1186/1741-7015-10-12. PMID 22300510. Unknown parameter
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ignored (help) - ↑ G. Z. Panos, G. I. Betsi & M. E. Falagas (2006). "Systematic review: are antibiotics detrimental or beneficial for the treatment of patients with Escherichia coli O157:H7 infection?". Alimentary pharmacology & therapeutics. 24 (5): 731–742. doi:10.1111/j.1365-2036.2006.03036.x. PMID 16918877. Unknown parameter
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ignored (help) - ↑ C. S. Wong, S. Jelacic, R. L. Habeeb, S. L. Watkins & P. I. Tarr (2000). "The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections". The New England journal of medicine. 342 (26): 1930–1936. doi:10.1056/NEJM200006293422601. PMID 10874060. Unknown parameter
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ignored (help) - ↑ . doi:10.1097/INF.0b013e31823096a8. Check
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(help) - ↑ K. Ikeda, O. Ida, K. Kimoto, T. Takatorige, N. Nakanishi & K. Tatara (1999). "Effect of early fosfomycin treatment on prevention of hemolytic uremic syndrome accompanying Escherichia coli O157:H7 infection". Clinical nephrology. 52 (6): 357–362. PMID 10604643. Unknown parameter
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ignored (help) - ↑ Nasia Safdar, Adnan Said, Ronald E. Gangnon & Dennis G. Maki (2002). "Risk of hemolytic uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 enteritis: a meta-analysis". JAMA. 288 (8): 996–1001. PMID 12190370. Unknown parameter
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ignored (help) - ↑ Mini Michael, Elizabeth J. Elliott, Greta F. Ridley, Elisabeth M. Hodson & Jonathan C. Craig (2009). "Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura". The Cochrane database of systematic reviews (1): CD003595. doi:10.1002/14651858.CD003595.pub2. PMID 19160220. Unknown parameter
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ignored (help) - ↑ Andreas Greinacher, Sigrun Friesecke, Peter Abel, Alexander Dressel, Sylvia Stracke, Michael Fiene, Friedlinde Ernst, Kathleen Selleng, Karin Weissenborn, Bernhard M. W. Schmidt, Mario Schiffer, Stephan B. Felix, Markus M. Lerch, Jan T. Kielstein & Julia Mayerle (2011). "Treatment of severe neurological deficits with IgG depletion through immunoadsorption in patients with Escherichia coli O104:H4-associated haemolytic uraemic syndrome: a prospective trial". Lancet (London, England). 378 (9797): 1166–1173. doi:10.1016/S0140-6736(11)61253-1. PMID 21890192. Unknown parameter
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ignored (help) - ↑ Yukihiko Kawasaki, Kazuhide Suyama, Atsushi Ono, Tomoko Oikawa, Shinichiro Ohara, Yuichi Suzuki, Nobuko Sakai & Mitsuaki Hosoya (2013). "Efficacy of recombinant human soluble thrombomodulin for childhood hemolytic uremic syndrome". Pediatrics international : official journal of the Japan Pediatric Society. 55 (5): e139–e142. doi:10.1111/ped.12165. PMID 24134770. Unknown parameter
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ignored (help) - ↑ Lindsay S. Keir, Stephen D. Marks & Jon Jin Kim (2012). "Shigatoxin-associated hemolytic uremic syndrome: current molecular mechanisms and future therapies". Drug design, development and therapy. 6: 195–208. doi:10.2147/DDDT.S25757. PMID 22888220.
- ↑ Marina Noris & Giuseppe Remuzzi (2005). "Hemolytic uremic syndrome". Journal of the American Society of Nephrology : JASN. 16 (4): 1035–1050. doi:10.1681/ASN.2004100861. PMID 15728781. Unknown parameter
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ignored (help) - ↑ Mini Michael, Elizabeth J. Elliott, Jonathan C. Craig, Greta Ridley & Elisabeth M. Hodson (2009). "Interventions for hemolytic uremic syndrome and thrombotic thrombocytopenic purpura: a systematic review of randomized controlled trials". American journal of kidney diseases : the official journal of the National Kidney Foundation. 53 (2): 259–272. doi:10.1053/j.ajkd.2008.07.038. PMID 18950913. Unknown parameter
|month=
ignored (help) - ↑ Mini Michael, Elizabeth J. Elliott, Greta F. Ridley, Elisabeth M. Hodson & Jonathan C. Craig (2009). "Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura". The Cochrane database of systematic reviews (1): CD003595. doi:10.1002/14651858.CD003595.pub2. PMID 19160220. Unknown parameter
|month=
ignored (help) - ↑ M. Glatstein, Miguel; Snehal, Vala; Amir Ahmad, Syed; Scolnik, Dennis (2012). "Are potassium levels in children with hemolytic uremic syndrome predictive of outcome?". Open Journal of Pediatrics. 02 (04): 264–267. doi:10.4236/ojped.2012.24043. ISSN 2160-8741.
- ↑ Julie A. Ake, Srdjan Jelacic, Marcia A. Ciol, Sandra L. Watkins, Karen F. Murray, Dennis L. Christie, Eileen J. Klein & Phillip I. Tarr (2005). "Relative nephroprotection during Escherichia coli O157:H7 infections: association with intravenous volume expansion". Pediatrics. 115 (6): e673–e680. doi:10.1542/peds.2004-2236. PMID 15930195. Unknown parameter
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ignored (help) - ↑ Gianluigi Ardissino, Francesca Tel, Ilaria Possenti, Sara Testa, Dario Consonni, Fabio Paglialonga, Stefania Salardi, Nicolo Borsa-Ghiringhelli, Patrizia Salice, Silvana Tedeschi, Pierangela Castorina, Rosaria Maria Colombo, Milena Arghittu, Laura Daprai, Alice Monzani, Rosangela Tozzoli, Maurizio Brigotti & Erminio Torresani (2016). "Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome". Pediatrics. 137 (1). doi:10.1542/peds.2015-2153. PMID 26644486. Unknown parameter
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ignored (help) - ↑ J. R. Brandt, L. S. Fouser, S. L. Watkins, I. Zelikovic, P. I. Tarr, V. Nazar-Stewart & E. D. Avner (1994). "Escherichia coli O 157:H7-associated hemolytic-uremic syndrome after ingestion of contaminated hamburgers". The Journal of pediatrics. 125 (4): 519–526. PMID 7931869. Unknown parameter
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ignored (help)