A 8 yr old boy presents with petechie, azotemic oligurea altered sensorium in casualty. There is history of diarrhoea for the past 5 days. The clinical diagnosis is -

Ans. is 'a' i.e., Hemolytic uremic syndrome The boys is suffering from hemolytic uremic syndrome. Hemolytic uremic syndrome HUS is characterized by the triad of - 1) Anemia (microangiopathic hemolytic anemia) 2) Renal failure (microangiopathy of kidney involving glomerular capillaries and aerioles). 3) Thrombocytopenia (due to platelet destruction) o HUS is common in children under 2 years of age. (But may also occur in older children). o It usually follows an episode of acute gastroenteritis. o The prodrome is usually of abdominal pain, diarrhoea and vomiting. Sholy thereafter, signs and symptoms of acute hemolytic anemia, thrombocytopenia and acute renal failure ensue. o Sometimes neurological findings also occur (But usually absent and differentiates HUS from TTP).