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Haemolytic Uraemic Syndrome — RACP Paediatrics MCQ

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ModerateNephrologyHaemolytic Uraemic SyndromeRACP Paediatrics

A 3-year-old girl presents with bloody diarrhoea for 5 days followed by pallor, oliguria, and irritability. Blood tests show Hb 65 g/L, platelets 45 × 10⁹/L, creatinine 350 μmol/L, and blood film shows schistocytes. What is the diagnosis?

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Correct answer: A — Haemolytic uraemic syndrome (HUS)

The triad of microangiopathic haemolytic anaemia (schistocytes on blood film), thrombocytopenia, and acute kidney injury following a diarrhoeal illness is diagnostic of typical (D+) haemolytic uraemic syndrome. The most common cause in children is Shiga toxin-producing E. coli (STEC), particularly O157:H7. Management is supportive; antibiotics may worsen outcome. Dialysis may be required.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Haemolytic Uraemic Syndrome