Haemolytic-uraemic syndrome: survival after prolonged oliguria.

Abstract

Since the original definition of the haemolyticuraemic syndrome by The clinical features usually include diarrhoea and vomiting of acute onset, succeeded by pallor and sometimes bruising or petechiae. Oliguria is common but its duration is variable and hypertension occurs in some cases. The blood picture shows a 'micro- angiopathic haemolytic anaemia' (Brain, Dacie, and Hourihane, 1962), with bizarre, distorted, and fragmented red blood cells, burr cells, poikilo- cytosis, anisocytosis, spherocytosis, and polychromasia. The direct Coombs test is negative, the reticulocyte count is raised, and thrombocytopenia of variable degree is often present. Haemoglobinaemia and haemoglobinuria occur in the more severe cases. The urine contains protein and red blood cells, and the blood urea is raised in proportion to the degree of oliguria. Compre- hensive reviews include those of