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Hemolytic-Uremic Syndrome
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Hemolytic-Uremic Syndrome

Clinical feature: 

Definition: This disease belongs to thrombotic microangiopathies. It is characterized by the presence of renal insufficiency and the absence of neurological signs not attributable to uremic encephalopathy.

Pathogenesis: Reduced plasma levels of factor H or dysfunction of this protein may lead to HUS. But there is evidence that other genetic factors also may induce HUS. The pathogenesis of H factor related HUS is deliniated on gene test description page.

Diagnostics: 

Strategy: Ancillary to the common laboratory investigations to confirm the diagnosis of thrombotic microangiopathy the measurement of factor H plasma levels are recommended. A mutation screening is required if the level is below normal. But cases have been reported in which normal plasma levels have been found despite of documented mutations. Consequently, if there were a family history of HUS, molecular genetic investigation would be indicated anyway.

Systematic link table: 

Thrombotic microangiopathies
Hemolytic-Uremic Syndrome
ADAMTS13
C3
CFB
CFH
CFHR1
CFHR2
CFHR3
CFHR4
CFHR5
CFI
MCP
THBD
Thrombotic Thrombocytopenic Purpura
ADAMTS13

Literature: 

Zipfel PF et al. (2001) Hemolytic uremic syndrome: how do factor H mutants mediate endothelial damage?
Shao C et al. (2004) Whole exon 5 and intron 5 replaced by RHCE in DVa(Hus).
Nürnberger J et al. (2009) Eculizumab for atypical hemolytic-uremic syndrome.
Noris M et al. (2010) Thrombotic microangiopathy after kidney transplantation.