16.5 Haemolytic uraemic syndrome
1 Diagnosis is based on the presence of microangiopathic haemolytic anaemia, thrombocytopenia and renal impairment.
Introduction
Epidemiology
Non-diarrhoeal-associated HUS (D– HUS) cases account for 10% of cases. These are secondary to:
• immunosuppression: malignancy-associated, following bone-marrow transplant, and drug-related, e.g. mitomycin, ciclosporin and FK-506 (tacrolimus);
Investigations
• Anaemia is usually severe and is normochromic normocytic in type with a haemoglobin level of 50–90 g L–1.
• Platelet count is low in 95% and can be as low as 20 × 109 L–1. Subsequent increase in platelet count may be the first indication of resolution of the microangiopathic process.

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