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					Diagnostic testing

      Diagnosis of HUS is primarily clinical, with corroborating evidence from laboratory
       studies
      Complete blood count (CBC): severe anemia is often present, as is thrombocytopenia
      Peripheral smear can demonstrate the telltale HUS evidence of microangiopathic
       hemolytic anemia with schistocytes, helmet cells, and burr cells
      Coagulation studies: Prothrombin time (PT) and partial thromboplastin time (PTT) are
       necessary to assess bleeding risk and to differentiate HUS from other disorders. These
       are usually normal in HUS
      Reticulocyte count tends to be high, a consequence of hemolysis
      Serum haptoglobin test is used to evaluate the presence of hemolysis, in which case,
       haptoglobin levels are low
      Lactate dehydrogenase (LDH) levels are elevated in HUS
      Bilirubin levels are often high, primarily due to elevation of the indirect
       (unconjugated) component
      Blood urea nitrogen and creatinine levels may be elevated, indicating renal
       insufficiency or failure
      Serum electrolytes levels need to be assessed to determine the presence of
       hyponatremia, hyperkalemia, or metabolic acidosis
      Urinalysis helps look for proteinuria, pyuria, and microscopic hematuria
      Stool culture and assay for E. coli O157:H7 during the first week of illness: Stool
       cultures for E. coli O157:H7 are positive in more than 90% of cases
      Renal ultrasonography should be performed in renal failure patients to eliminate the
       possibility of kidney obstruction or small kidneys from pre-existing chronic renal
       disease

				
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posted:8/16/2011
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