Academic Journal

Complement-Mediated Thrombotic Microangiopathy Associated with Lupus Nephritis Treated with Eculizumab: A Case Report

Bibliographic Details
Title: Complement-Mediated Thrombotic Microangiopathy Associated with Lupus Nephritis Treated with Eculizumab: A Case Report
Authors: Everardo Arias Torres, Yongen Chang, Sheetal Desai, Ian Chang, Jonathan E. Zuckerman, Richard Burwick, Kamyar Kalantar-Zadeh, Ramy M. Hanna
Source: Case Reports in Nephrology and Dialysis, Vol 11, Iss 1, Pp 95-102 (2021)
Publisher Information: Karger Publishers, 2021.
Publication Year: 2021
Collection: LCC:Diseases of the genitourinary system. Urology
Subject Terms: thrombotic microangiopathy, systemic lupus erythematosus, complement-mediated thrombotic microangiopathy, glomerular disease, pregnancy, atypical hemolytic uremic syndrome, Diseases of the genitourinary system. Urology, RC870-923
Description: Thrombotic microangiopathies (TMAs) involve multiple organ systems due to the presence of microangiopathic hemolysis. One such condition, atypical hemolytic uremic syndrome (aHUS), is a complement-mediated process that is part of a spectrum of disorders that have underlying complement dysfunction of the alternative pathway due to overactivity or decreased self-nonself discrimination by innate immunity. Complement-amplifying conditions such as pregnancy may unmask a diagnosis of aHUS. We present an important case of a pregnant 23-year-old Hispanic female who presented in mid-gestation (21 weeks) with an initial diagnosis of systemic lupus erythematosus (SLE) complicated by aHUS. She met clinical criteria for aHUS on presentation and was found to have a pathogenic CFHR1–3 homozygous deletion. She has been treated with intravenous and oral steroids, cyclophosphamide, subsequently also with plasma exchange, and finally with eculizumab with partial improvement in renal function. This case adds to the emerging literature showing that SLE and aHUS (or complement-mediated TMA) can be successfully treated with C5 blockade.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-9705
Relation: https://www.karger.com/Article/FullText/512227; https://doaj.org/toc/2296-9705
DOI: 10.1159/000512227
Access URL: https://doaj.org/article/f515cd6f4e5a4e25a3b91f54a4950056
Accession Number: edsdoj.f515cd6f4e5a4e25a3b91f54a4950056
Database: Directory of Open Access Journals
Description
ISSN:22969705
DOI:10.1159/000512227