A 3-year-old boy presents with 5 days of bloody diarrhea and now oliguria. Vital signs: BP 128/82 mmHg, HR 118/min, RR 24/min, Temp 37.2°C, SpO2 98% on room air. Serum creatinine is 2.8 mg/dL (baseline 0.4). Hemoglobin 7.2 g/dL, platelets 45,000/μL. Peripheral blood smear reveals schistocytes. Stool culture grows Shiga toxin-producing Escherichia coli. Urinalysis shows no proteinuria. Which of the following is the most likely diagnosis?
- A)Disseminated intravascular coagulation
- B)Hemolytic uremic syndromeGABARITO
- C)IgA nephropathy
- D)Acute post-infectious glomerulonephritis
- E)Thrombotic thrombocytopenic purpura
Explicação
Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy caused by Shiga toxin from enterohemorrhagic E. coli (O157:H7). Classic presentation is bloody diarrhea followed by AKI, microangiopathic hemolytic anemia (schistocytes), and thrombocytopenia. HUS... Ver explicação completa e trilha adaptativa →