A 4-year-old child becomes very sick after eating undercooked ground beef. Kidney function tests are very elevated. Thrombocytopenia is mild, and a few schistocytes are noted on the blood film. Which of the following is most likely diagnosis?
a. Immune thrombocytopenic purpura
b. Thrombotic thrombocytopenic purpura
c. Hemolytic uremic syndrome
d. DIC
ANS: C
Hemolytic uremic syndrome is found primarily in children between the ages of 6 months to 4 years. About 90% of the cases are caused by Shigella dysenteriae serotypes or enterohemorrhagic Escherichia coli OH serotypes, particularly O157:H7. Hyaline thrombi form in the renal vasculature, leading to renal failure, thrombocytopenia, and a microangiopathic hemolytic anemia with some red cell fragmentation.
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