Tag Archives: renal disease

April PDF digest ready to go

April 30, 2022Uncategorizedhaematology, infectious disease, mental health issues, parenting, renal diseaseJulia

This month‘s newsletter has some helpful resources for parents of children of all ages. Also a reminder from Islington borough of London that children should be at school if they have minor illnesses. Everyone gets muddled up with HSP and ITP so we’ve put together a comparison table. Do leave comments below…

August 2020 PDF

August 27, 2020Uncategorizedpaediatric surgery, psychology, renal disease, speech and languageJulia

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Acute Kidney Injury (AKI) by Alex Argyropoulos this month: risk, recognition and management. Surgical update on hernias, the difficulties of wearing masks for people who stutter and a helping hand from Harry the Hound for children worried about going back to school after covid.

Please do leave comments below.

August 2019 Paediatric Pearls newsletter uploaded

August 30, 2019Uncategorizeddermatology, haematology, infectious disease, malaria, neurology, renal disease, viral infectionsJulia

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More on the coca-cola urine story this month, NF type I, cerebellar ataxia and restless legs syndrome. Do leave comments below.

June 2019 newsletter

June 23, 2019For Emergency Departments, For General Practitioners, PDF digests: Emergency Departments, PDF digests: for General Practitionerschild protection, haematology, neurology, renal disease, safeguarding, urinalysisJulia

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Possible causes of macrocephaly this month. Also the start of a new series on causes of coca-cola coloured urine and updates on safeguarding CPD requirements and the terminology of children “in care”. Do leave comments below:

November 2018 published

November 30, 2018Uncategorizedchild protection, renal disease, safeguarding, sexual healthJulia

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STIs, sexual abuse, eating disorder and haemolytic uraemic syndrome this month. Do leave comments below:

Haemolytic Uraemic Syndrome (HUS)

November 27, 2018Uncategorizedgastrointestinal issues, haematology, infectious disease, renal diseaseJulia

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With thanks to Dr David Gardiner, one of our current paediatric FY2 doctors at Homerton University Hospital, for updating us on HUS.

News story from 2018. Less than 3% of patients die of HUS but 20-30% experience adverse renal outcomes. Think about it in children with bloody diarrhoea and, often, no fever.

Presentation:

Profuse diarrhoea that typically turns bloody after 1-3 days
Abdominal pain (crampy)
Vomiting
Fever (sometimes)
Oedema
Reduced urine output (abrupt onset) but also polyuria/normal urine output (rarer)
Neurological complications: seizure, coma, cranial nerve palsies, confusion, hallucinations
Classic triad – anaemia, uraemia and thrombocytopaenia
Most common in children under the age of 5

Investigations:

B/P – hypertension
Blood film: Fragmentation and signs of haemolysis (Coombs test negative)
Raised WCC and neutrophils, low platelets, low Hb
Raised LDH
Clotting screen typically normal (cf DIC)
Raised bilirubin, low albumin
Urea and creatinine raised
Stool for PCR E.Coli

Management:

Refer to secondary care urgently
Strict input/output fluid monitoring
Correction of anaemia
Correction of electrolyte imbalances
Antihypertensive therapy if required
Dialysis
Furosemide to induce diuresis
Report to PHE – can’t go back to school until 2 negative stool samples

More resources:

Kidney Research website on HUS

https://patient.info/doctor/haemolytic-uraemic-syndrome-pro#ref-8