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Haemolytic uraemic syndrome — RACP Paediatrics MCQ

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HardRenalHaemolytic uraemic syndromeRACP Paediatrics

A 3-year-old has bloody diarrhoea followed five days later by pallor, reduced urine output and lethargy. Blood tests show anaemia with schistocytes, platelets 42 x 10^9/L and rising creatinine. What is the most appropriate management?

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Correct answer: D — Supportive care with renal monitoring and early nephrology involvement

The triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury after bloody diarrhoea is typical of Shiga-toxin associated HUS; treatment is supportive with careful fluid, blood pressure and renal management. Platelets are avoided unless significant bleeding or procedures are planned. The pearl is that antimotility drugs are inappropriate in suspected Shiga-toxin diarrhoea.

Reference: RCH Clinical Practice Guidelines: Haemolytic uraemic syndrome; Therapeutic Guidelines (eTG)