Hemolytic Uremic Syndrome/Thrombotic Thrombocytopenic Purpura in the ICU

  • J. G. Zijlstra
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1999)


Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are the extremes of a spectrum of clinical presentations [1] of a rare disease first described in 1924 [2] and 1925 [3] by Moschcowitz. The syndrome has a complex etiology and multiorgan involvement. The one common pathological feature of HUS/TTP, in all forms of presentation of this syndrome, is the pathognomonic thrombotic microvascular lesion (Fig. 1). Although thrombotic microangiopathy might be a better, and more unifying, name [1, 4–6], we will refer to the syndrome as HUS/TTP unless the cited literature is more specific. If untreated, HUS/TTP is a syndrome with a high mortality. Despite the fact that the mortality has decreased from 90% to 10–20% [1, 7–14] some patients with HUS/TTP still need intensive care unit (ICU) admission. The reduction in mortality is partly due to improved supportive therapy, of which renal replacement therapy is the most important [12]. The reason for an ICU admission is to provide adequate treatment of cardio-pulmonary complications and the remaining important causes of death [12]. Neurological complications, which occur mostly in the initial phase of the disease, are also important causes of death [9–12]. Buying time is essential because the disease process can be self-limiting and response to therapy requires time.


Plasma Exchange Hemolytic Uremic Syndrome Thrombotic Thrombocytopenic Purpura Shiga Toxin Plasma Infusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  • J. G. Zijlstra

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