COVID-19-associated atypical hemolytic uremic syndrome and use of Eculizumab therapy

Gill, Jasmeet; Hebert, Christopher; Colbert, Gates B.

doi:10.1007/s40620-021-01125-8

Cited by 16 publications

(14 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To our knowledge, several cases of TMA associated with COVID-19 have already been reported to date [ 8 - 13 ]. Interestingly, in a significant proportion of the reported cases (including ours), the patients had no respiratory symptoms of COVID-19, but presented with gastrointestinal symptoms, such as nausea, vomiting and abdominal discomfort [ 14 - 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with the proposed complement-mediated nature of the disease [ 51 ], anti-complement therapy may be used in patients with aHUS to supplement TPE and prevent progression of renal failure. In some cases of COVID-19-associated TMA, the use of eculizumab [ 18 , 29 ] and recently ravulizumab [ 13 ], both anti-C5 monoclonal antibodies, led to positive results.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Coronavirus Disease 2019-Associated Thrombotic Microangiopathy

Vrecko¹,

Večerić-Haler²

2022

J Hematol

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) has spread tremendously since its first appearance in December 2019. Infected individuals can experience a wide range of systemic complications, including thrombotic microangiopathy (TMA). Like the other forms of TMA, COVID-19-associated TMA is characterized by thrombocytopenia, hemolytic anemia, and organ failure (such as acute kidney injury). The role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in COVID-19-associated TMA is most probably dual: it can act either as a trigger to an underlying condition or as a cause of TMA. As opposed to the majority of other reported cases, it may be that in our case COVID-19 was the only cause of TMA. We present a case of a 32-year-old previously healthy man who was treated for acute kidney injury associated with TMA, which we believe was caused by COVID-19. Thrombotic thrombocytopenic purpura, as well as other possible known causes of typical and atypical hemolytic-uremic syndrome, was excluded. During his hospitalization, three negative nasopharyngeal swabs for SARS-CoV-2 were obtained, but serological tests showed the presence of IgG and IgA antibodies. After initial treatment known to be helpful in other forms of TMA (therapeutic plasma exchange and methylprednisolone), his renal function and platelet count recovered completely. Our case illustrates the importance of quickly recognizing this life-threatening complication of COVID-19 and using treatment that has been shown to be beneficial in other forms of TMA. Future studies of the pathophysiology and subsequent targeted treatment of this novel disease are needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coronavirus Disease 2019-Associated Thrombotic Microangiopathy

Vrecko¹,

Večerić-Haler²

2022

J Hematol

View full text Add to dashboard Cite

show abstract

“…The treatment provided to these patients and the clinical outcome are summarized in Table 2 [ 3 , 6 , 8 , 13 , 14 ]. The treatment options included eculizumab or ravulizumab, a new complement component C5 inhibitor [ 15 ].…”

Section: Discussionunclassified

“…[3,6,8,13,14]. The treatment options included eculizumab or ravulizumab, a new complement component C5 inhibitor[15].…”

mentioning

confidence: 99%

COVID-19: A Rare Cause of Hemolytic Uremic Syndrome

Boldig¹,

Batra²,

Villegas³

2022

Cureus

View full text Add to dashboard Cite

Hemolytic uremic syndrome (HUS) is a multisystemic condition characterized by a triad of acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. HUS can be classified as atypical or typical, depending upon its association with the Shiga toxin-producing Escherichia coli (STEC). Approximately 90-95% of cases are classified as typical, while only 5-10% of cases are atypical. The pathogenesis of atypical HUS (aHUS) occurs when the complement cascade is activated and causes membrane attack complex (MAC) deposition in the renal tubular epithelium. Various infectious triggers have been associated with aHUS. A new and compelling correlation to this rare and potentially deadly diagnosis of aHUS is COVID-19 infection or vaccination. We present a case of COVID-19-induced exacerbation of a patient with a known history of aHUS. In addition, we performed a literature review of previously reported COVID-19-induced aHUS cases and identified the potential pathogenesis of the disease state.

show abstract

“…The sustained activation of alternative pathway of complement with virus component leads to severe inflammation beside the coagulation activity (5)(6)(7).…”

Section: Hemolytic Uremic-like Syndromementioning

confidence: 99%