Atypical hemolytic uremic syndrome

Información en español Title

Other Names:

aHUS; Atypical HUS; HUS, atypical

Categories:

Blood Diseases

Summary Summary

Atypical hemolytic uremic syndrome (aHUS) is a disease that causes abnormal blood clots to form in small blood vessels in the kidneys. These clots can cause serious medical problems if they restrict or block blood flow, including hemolytic anemia, thrombocytopenia, and kidney failure. It can occur at any age and is often caused by a combination of environmental and genetic factors. Genetic factors involve genes that code for proteins that help control the complement system (part of your body’s immune system). Environmental factors include certain medications (such as anticancer drugs), chronic diseases (e.g., systemic sclerosis and malignant hypertension), viral or bacterial infections, cancers, organ transplantation, and pregnancy. In about 60% of aHUS, a gene mutation may be identified. The genes associated with genetic aHUS include C3,
CD46 (MCP), CFB, CFH, CFHR1, CFHR3, CFHR4, CFI, DGKE, and THBD. Mutations in these genes increase the likelihood (predisposition) to developing aHUS, rather than directly causing the disease. Most cases are sporadic. In familiar cases, predisposition to aHUS is inherited in an autosomal dominant or an autosomal recessive pattern of inheritance.^[1]^[2]

Atypical hemolytic uremic syndrome differs from a more common condition called typical hemolytic uremic syndrome. The two disorders have different causes and different signs and symptoms.^[2]

Last updated: 1/23/2017

Symptoms Symptoms

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
80%-99% of people have these symptoms
Abnormal lactate dehydrogenase activity		0045040
Acute kidney injury		0001919
Hematuria	Blood in urine	0000790
Microangiopathic hemolytic anemia		0001937
Proteinuria	High urine protein levels Protein in urine [ more ]	0000093
Thrombocytopenia	Low platelet count	0001873
30%-79% of people have these symptoms
Decreased level of thrombomodulin		0040229
Decreased serum complement factor B		0005416
Decreased serum complement factor I		0005356
Percent of people who have these symptoms is not available through HPO
Anuria	Absent urine output	0100519
Autosomal dominant inheritance		0000006
Autosomal recessive inheritance		0000007
Cognitive impairment	Abnormality of cognition Cognitive abnormality Cognitive defects Cognitive deficits Intellectual impairment Mental impairment [ more ]	0100543
Coma		0001259
Decreased serum complement C3		0005421
Decreased serum complement factor H		0005369
Diarrhea	Watery stool	0002014
Dysphasia		0002357
Elevated serum creatinine	Elevated creatinine High blood creatinine level Increased creatinine Increased serum creatinine [ more ]	0003259
Fever		0001945
Hemiparesis		0001269
Hemolytic-uremic syndrome		0005575
Hyperlipidemia		0003077
Hypertension		0000822
Increased blood urea nitrogen		0003138
Purpura		0000979
Reticulocytosis		0001923
Schistocytosis		0001981
Seizures	Seizure	0001250

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Do you have more information about symptoms of this disease? We want to hear from you.

Last updated: 6/1/2018

Diagnosis Diagnosis

GeneTests lists the names of laboratories that are performing genetic testing for atypical hemolytic-uremic syndrome. To view the contact information for the clinical laboratories conducting testing click here and follow the "testing" link pertaining to each gene.

Please note: Most of the laboratories listed through GeneTests do not accept direct contact from patients and their families; therefore, if you are interested in learning more, you will need to work with a health care provider or a genetics professional. In the Genetic Services section of this letter we provide a list of online resources that can assist you in locating a genetics professional near you.

Last updated: 3/26/2012

Treatment Treatment

FDA-Approved Treatments

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products.

Eculizumab (Brand name: Soliris) - Manufactured by Alexion Pharmaceuticals, Inc.
FDA-approved indication: For the treatment of atypical Hemolytic Uremic Syndrome (aHUS).
National Library of Medicine Drug Information Portal
Medline Plus Health Information

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Find a Specialist Find a Specialist

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

The Foundation for Children with Atypical HUS offers a 'Doc to Doc Registry' for physicians wishing to connect with other doctors experienced with the complexities of atypical HUS. Click on the link above to read more about this service.
To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.

Research Research

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

ClinicalTrials.gov lists trials that are related to Atypical hemolytic uremic syndrome. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Patient Registry

The International Registry of Recurrent and Familial Hemolytic Uremic Syndrome (HUS) and Thrombotic Thrombocytopenic Purpura (TTP) is a research registry that aims to study the genetic and biochemical abnormalities of HUS/TTP, collect clinical and genetic data of patients and their families, find the best therapeutic approach for patients, and provide up-to-date information to physicians and families. Click on the link embedded link above to learn more about the registry.
The aHUS Registry is a worldwide collection of data aiming at improving and sharing the understanding of aHUS for a better management of patients with aHUS. Information for patients interested in participating in this registry can be accessed here.

Organizations Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

aHUS Alliance
E-mail: info@ahusallianceaction.org
Website: http://www.ahusallianceaction.org/
American Association of Kidney Patients
3505 E. Frontage Rd., Suite 315
Tampa, FL 33607-1796
Toll-free: 800-749-2257
Telephone: 813-636-8100
Fax: 813-636-8122
E-mail: info@aakp.org
Website: http://www.aakp.org
American Kidney Fund, Inc.
6110 Executive Boulevard
Suite 1010
Rockville, MD 20852
Toll-free: 800-638-8299
Telephone: 301-881-3052
E-mail: helpline@kidneyfund.org
Website: http://www.kidneyfund.org
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Toll-free: 800-622-9010
Telephone: 212-889-2210
Fax: 212-689-9261
E-mail: info@kidney.org
Website: http://www.kidney.org
The Foundation for Children with Atypical HUS
Website: http://www.atypicalhus.org

Social Networking Websites

RareConnect has an online community for patients and families with this condition so they can connect with others and share their experiences living with a rare disease. The project is a joint collaboration between EURORDIS (European Rare Disease Organisation) and NORD (National Organization for Rare Disorders).

Do you know of an organization? We want to hear from you.

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

The Merck Manual provides information on the complement system. The Merck Manuals are a series of healthcare books for medical professionals and consumers.
The Foundation for Children with Atypical HUS provides further information on atypical HUS on their Web site. Click on the link above to view the information page.
Genetics Home Reference (GHR) contains information on Atypical hemolytic uremic syndrome. This website is maintained by the National Library of Medicine.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Atypical hemolytic uremic syndrome. Click on the link to view a sample search on this topic.

Selected Full-Text Journal Articles

Goodship THJ, Cook HT, Fakhouri F, Fervenza FC, Fremeaux-Bacchi V, Kavanaugh D, Nester CM, Noris M, Pickering MC, Rodriguez de Cordoba S, Roumenina LT, Sethi S, Smith RJH. Atypical hemolytic uremic syndrome and C3 glomerulopathy: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference Kidney International. March 2017; 91(3):539-551.

GARD Answers GARD Answers

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

My brother in law has just been diagnosed with atypical hemolytic-uremic syndrome (aHUS) and has suffered kidney failure. We have found out his cousin also has it. One of our concerns is for my husband and our two children. Is there a way that they can be tested to rule out aHUS? See answer

Have a question? Contact a GARD Information Specialist.

References References

Alpers CE. The Kidney. In: Kumar ed. Robbins and Cotran Pathologic Basis of Disease, Professional Edition , 8th ed. Philadelphia, PA: Saunders; 2009;
Atypical hemolytic-uremic syndrome. Genetics Home Reference. 2010; http://ghr.nlm.nih.gov/condition/atypical-hemolytic-uremic-syndrome. Accessed 9/27/2010.

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