Hemolytic-uremic syndrome colitis.

The hemolytic-uremic syndrome has varied prodromal symptoms. In a few patients the dominant initial gastrointestinal symptoms have led to a presumptive diagnosis of ulcerative colitis. The colitis tends to be self-limited, to have minimal lesions detected by proctoscopic or roentgenographic studies, and usually to resolve spontaneous without specific therapy. Rarely, more serious colonic involvement can progress to toxic megacolon, rectal prolapse, colonic perforation, intussusception, or colonic stricture. Early hemodialysis will reduce morbidity and mortality in patients with severe renal impairment. The physician should be aware of this entity when young patients present with a picture compatible with ulcerative colitis in order to circumvent delayed or inappropriate management of what would appear to be a primary bowel disorder.