This case describes an unusual presentation of an adolescent with signs of neurological, gastrointestinal and renal dysfunction. The article explores a wide range of differential diagnoses, including cerebral and renal pathologies before identifying haemolytic uraemic syndrome (HUS) as the underlying cause. The article discusses the neurological and biochemical abnormalities, interpreting the link between systemic and central nervous system involvement, and highlights the importance of early recognition, fluid management and appropriate escalation. This case reinforces key learning around HUS with cerebral manifestations, its prognostic implications and the vital role of multidisciplinary care in managing this complex condition.
Undergraduate medical students receive extensive communication skills teaching, but little formal training in how to communicate with children who are unable or reluctant to use speech. We identified this as a curriculum gap in undergraduate education. In this quality improvement project we developed, refined and embedded a co-produced teaching programme on augmentative and alternative communication (AAC) across two UK medical schools. The teaching package was co-designed with speech and language therapists (SLTs), clinical educators, expert parents, neurodiverse young people and medical students and refined through sequential plan-do-study-act (PDSA) cycles. Across three pilots, 153 medical students attended, of whom 139 completed paired pre-and post-training feedback. Self-reported confidence in taking a history from a reluctant child increased from 7% before teaching to 98% afterwards, and understanding of AAC application increased from 12% to 98%. Now embedded into undergraduate teaching at both participating medical schools, the intervention supports a wider shift towards making basic AAC-informed communication part of every future doctor's approach to child-centred care.
