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  • Hus DDX

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    Joan Luis
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    A 7-year-old Filipino male presented with a 1-week history of cough and 1-day history of fever, tea-colored urine, bruising, pallor, and vomiting. On examination, he was noted to have hypotension, tachycardia, abdominal tenderness, bruising on his legs, pale nailbeds, and pallor. His labs showed anemia, thrombocytopenia, and albuminuria. His creatinine was elevated. The admitting impression was hemolytic uremic syndrome.

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    HUS-DDX

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    A 7-year-old Filipino male presented with a 1-week history of cough and 1-day history of fever, tea-colored urine, bruising, pallor, and vomiting. On examination, he was noted to have hypotension, tachycardia, abdominal tenderness, bruising on his legs, pale nailbeds, and pallor. His labs showed anemia, thrombocytopenia, and albuminuria. His creatinine was elevated. The admitting impression was hemolytic uremic syndrome.

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    17 views6 pages

    Hus DDX

    Uploaded by

    Joan Luis
    A 7-year-old Filipino male presented with a 1-week history of cough and 1-day history of fever, tea-colored urine, bruising, pallor, and vomiting. On examination, he was noted to have hypotension, tachycardia, abdominal tenderness, bruising on his legs, pale nailbeds, and pallor. His labs showed anemia, thrombocytopenia, and albuminuria. His creatinine was elevated. The admitting impression was hemolytic uremic syndrome.

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    of 6

    SALIENT FEATURES

    • 7y.o. • BP 100/60 • HYPOGASTRIC


    • 115 BPM TENDERNESS
    • MALE
    • 27 CPM • DEC. BS, RLLF
    • FILIPINO • 36.8 C • PALLOR
    • ASIAN • 94 % • HEMATOMAS ON LE
    • CC: VOMITING & BRUISING • 20.5 KG • PALE NAILBEDS
    • 120 CM
    • 1WK-COUGH
    • 1DAY- FEVER, TEA COLORED • ANEMIA 77-83
    URINE, BRUISING, PALLOR, • THROMBOCYTOPENIA 105-125
    VOMITING • ALBUMINURIA +++
    • CREATININE : 174.8
    ADMITTING IMPRESSION

    HEMOLYTIC UREMIC
    SYNDROME
    THROMBOTIC THROMBOCYTOPENIC PURPURA

    RULE IN RULE OUT


    • 1DAY • (-) CNS CHANGES
     FEVER, • (-) FEVER
     TEA COLORED URINE, • USUALLY PRESENTS IN ADULTS OCC. IN
     BRUISING, ADOLESCENTS
     PALLOR, • TTP CAN HAVE A MORE GRADUAL ONSET
     VOMITING, • PBS: MICROANGIOPATHIC HEMOLYTIC ANEMIA
     ABDOMINAL PAIN
    • INITIAL SYMPTOMS OF PAIN, WEAKNESS, EMESIS

    • ANEMIA 77-83
    • THROMBOCYTOPENIA 105-125
    • ALBUMINURIA +++
    • CREATININE : 174.8
    HENOCH SCHONLEIN PURPURA
    RULE IN RULE OUT
    • 1DAY • (-) PURPURIC RASH
     FEVER, • (-) ARTHRITIS
     TEA COLORED URINE,
     BRUISING,
     PALLOR,
     VOMITING,
     ABDOMINAL PAIN
    • SUDDEN ONSET
    RHEUMATIC FEVER
    RULE IN RULE OUT
    • 1DAY • (-) polyarthritis
     FEVER, • (-) arthralgia
     TEA COLORED URINE, • (-) subcutaneous nodules
     BRUISING, • (-) erythema marginatum
     PALLOR, • (-) sydenham chorea
     VOMITING, • (-) leukocytosis
     ABDOMINAL PAIN
    • INITIAL SYMPTOMS OF PAIN, WEAKNESS, EMESIS
    LUPUS NEPHRITIS
    RULE IN RULE OUT
    • 1DAY • (-) fatigue
     FEVER, • (-) arthralgia
     TEA COLORED URINE, • (-) arthritis
     BRUISING, • (-) malar rash
     PALLOR, • (-) discoid rash
     VOMITING, • (-) photosensitivity
     ABDOMINAL PAIN • (-) oral/nasal ulcers
    • ANEMIA 77-83
    • THROMBOCYTOPENIA 105-125
    • ALBUMINURIA +++
    • CREATININE : 174.8

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