Hemolytic-uremic syndrome

Toggle: English / Spanish


Shiga-like toxin producing E. coli hemolytic-uremic syndrome (STEC-HUS) is a disorder that usually occurs when an infection in the digestive system produces toxic substances that destroy red blood cells, causing kidney injury.

Alternative Names



Hemolytic-uremic syndrome (HUS) often occurs after a gastrointestinal infection with E. coli bacteria (Escherichia coli O157:H7). However, the condition has also been linked to other gastrointestinal infections, including

and , as well as nongastrointestinal infections.

HUS is most common in children. It is the most common cause of acute kidney failure in children. Several large outbreaks in 1992 and 1993 were linked to undercooked hamburger meat contaminated with E. coli.

STEC-HUS is not to be confused with atypical HUS (aHUS) which is not infection-related and is similar to another disease called thrombotic thrombocytopenic purpura (TTP).


STEC-HUS often begins with vomiting and diarrhea, which may be bloody. Within a week, the person may become weak and irritable. Persons with this condition may urinate less than normal. Urine output may almost stop.

Red blood cell destruction leads to symptoms of anemia.

Early symptoms:

Later symptoms:

Exams and Tests

The health care provider will perform a physical exam. This may show:

  • Liver or spleen swelling
  • Nervous system changes

Laboratory tests will show signs of

and . Tests may include:

Other tests:


Treatment may involve:

  • Dialysis
  • Medications such as corticosteroids
  • Transfusions of packed red blood cells and platelets

Outlook (Prognosis)

This is a serious illness in both children and adults, and it can cause death. With proper treatment, more than half of patients will recover. The outcome is better in children than adults.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of HUS. Emergency symptoms include:

  • Blood in the stool
  • No urination
  • Reduced alertness (consciousness)

Call your health care provider if you have had an episode of HUS and your urine output decreases, or you develop other new symptoms.


You can prevent the known cause, E. coli, by cooking hamburger and other meats well and by avoiding contact with unclean water.


Abrams CS. Thrombocytopenia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 175.

Version Info

  • Last reviewed on 2/24/2014
  • Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch)

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2013 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.