Hemolytic uremic syndrome presents with which combination of findings?

• A. Hypertension and edema
• B. Anemia with pallor, thrombocytopenia with petechiae, and acute kidney injury
• C. Hyperglycemia
• D. Weight gain

Answer: (B)

Hemolytic uremic syndrome is characterized by a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. The small-vessel damage from toxin-activated or immune-mediated processes creates microthrombi that shear red blood cells as they pass through, leading to anemia and pallor. Platelet consumption in those clots causes low platelets and can produce petechiae. Simultaneously, the kidneys suffer ischemic injury from the same microthrombi, resulting in acute kidney injury with reduced urine output and rising creatinine. While hypertension and edema can occur with kidney involvement, the combination of anemia with pallor, low platelets with petechiae, and AKI best captures the disease pattern. Hyperglycemia or weight gain are not typical features of this condition.