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Rapid Resolution of Atypical Hemolytic Uremic Syndrome by Eculizumab Treatment

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주제분류소아과학

초록

Atypical hemolytic uremic syndrome (aHUS) is an extremely rare and life-threatening disorder. Typical HUS is often caused by Shiga toxin-positive Escherichia coli , while aHUS is caused by dysregulation of the alternative pathway of the complement system in association with genetic abnormalities or development of autoantibodies. Eculizumab, a humanized anti-complement 5 monoclonal antibody, is recommended for the treatment of aHUS, but its long-term safety and efficacy in pediatric patients remain under review. In this paper, we report a pediatric case of aHUS with anti-complement factor H autoantibodies, who was treated successfully with eculizumab.

Abstract

Atypical hemolytic uremic syndrome (aHUS) is an extremely rare and life-threatening disorder. Typical HUS is often caused by Shiga toxin-positive Escherichia coli , while aHUS is caused by dysregulation of the alternative pathway of the complement system in association with genetic abnormalities or development of autoantibodies. Eculizumab, a humanized anti-complement 5 monoclonal antibody, is recommended for the treatment of aHUS, but its long-term safety and efficacy in pediatric patients remain under review. In this paper, we report a pediatric case of aHUS with anti-complement factor H autoantibodies, who was treated successfully with eculizumab.

참고문헌 (13)

  1. Calvaruso L, "Deterioration in Clinical Status Is Not Enough to Suspend Eculizumab : A Genetic Complement-Mediated Atypical Hemolytic Uremic Syndrome Case Report", Case Rep Nephrol, 2019, pp.9264824~ (2019)
  2. Brocklebank V, "Thrombotic Microangiopathy and the Kidney", Clin J Am Soc Nephrol, 13, pp.300~317 (2018)
  3. Fakhouri F, "Anticomplement Treatment in Atypical and Typical Hemolytic Uremic Syndrome", Semin Hematol, 55, pp.150~158 (2018)
  4. Dedhia P, "Eculizumab and Belatacept for De Novo Atypical Hemolytic Uremic Syndrome Associated With CFHR3-CFHR1Deletion in a Kidney Transplant Recipient : A Case Report", Transplant Proc, 49, pp.188~192 (2017)
  5. Farias JS, "A case of renal recovery in atypical hemolytic uremic syndrome treated with eculizumab", J Bras Nefrol, 38, pp.137~141 (2016)
  6. Menne J, "Outcomes in patients with atypical hemolytic uremic syndrome treated with eculizumab in a long-term observational study", BMC Nephrol, 20, pp.125~ (2019)
  7. Ariceta G, "Optimal duration of treatment with eculizumab in atypical hemolytic uremic syndrome(aHUS)-a question to be addressed in a scientific way", Pediatr Nephrol, 34, pp.943~949 (2019)
  8. Sridharan M, "Atypical hemolytic uremic syndrome: Review of clinical presentation, diagnosis and management", J Immunol Methods, 461, pp.15~22 (2018)
  9. Raina R, "Optimal management of atypical hemolytic uremic disease : challenges and solutions", Int J Nephrol Renovasc Dis, 12, pp.183~204 (2019)
  10. Cao M, "Eculizumab Modifies Outcomes in Adults with Atypical Hemolytic Uremic Syndrome with Acute Kidney Injury", Am J Nephrol, 48, pp.225~233 (2018)
  11. Jiang H, "Association among Complement Factor H Autoantibodies, Deletions of CFHR, and the Risk of Atypical Hemolytic Uremic Syndrome", Int J Environ Res Public Health, 13 (2016)
  12. Loirat C, "An international consensus approach to the management of atypical hemolytic uremic syndrome in children", Pediatr Nephrol, 31, pp.15~39 (2016)
  13. Philavanh Kedsatha, "Atypical Hemolytic Uremic Syndrome in a 13-year-old Lao Girl: A Case Report", Childhood Kidney Diseases, 23(1), pp.43~47 (2019), 대한소아신장학회[DOI]

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