A 4-year-old, previously well girl was admitted to an outside hospital with an acute illness consisting of abdominal pain, watery diarrhea, and nonbilious vomiting. She was presumed to have an acute gastroenteritis with dehydration. She was transferred to our institution 48 hours later after her diarrhea became bloody. The patient's white blood cell count was 39× 109/L and rising, her platelet count was 90 × 109/L and falling, and her hemoglobin level was 100 g/L and falling. Only erythematous mucosa was found at proctoscopy. Abdominal roentgenography (Fig 1) and barium enema examination (Fig 2) were performed.
Denouement and Discussion
Gastrointestinal Manifestations of Hemolytic Uremic Syndrome
Hemolytic uremic syndrome (HUS) is a disease of unknown origin usually occurring in children younger than 4 years. The pathologic findings resemble a microangiopathy and are associated with an angiitis and the formation of platelet thrombi resulting in the classic triad
Poe LB, Wood BP. Radiological Cases of the Month. Am J Dis Child. 1989;143(12):1481–1482. doi:10.1001/archpedi.1989.02150240103028