Uso do eculizumab na síndrome hemolítico urêmica atípica associada a comprometimento da função renal: revisão integrativa

Lima, Janielle Ferreira de Brito; Teixeira, Etenilde Dias dos Santos; Linhares, Laíla Silva; Barros, Eremilta Silva; Rolim, Isaura Letí­cia Tavares Palmeira

doi:10.17696/2318-3691.26.1.2019.1222

Cited by 1 publication

(1 citation statement)

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“…In the second case, eculizumab therapy was introduced 15 days after the initial suspicion of aHUS. Eculizumab, a human monoclonal antibody that stops the activation of the C5 complement component and the final complement formation, has recently been shown to be effective in the treatment of aHUS [ 28 – 30 ]. It helps in the recovery of kidney function and can completely change the prognosis of this potentially catastrophic disorder [ 31 ].…”

Section: Case Discussionmentioning

confidence: 99%

Thrombotic microangiopathy associated with arboviral infection: Report of 3 cases

et al. 2021

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Dengue fever and chikungunya are viral diseases that have spread rapidly throughout the world in recent decades. The occurrence of complications is well known, including prerenal acute kidney injury (AKI), which is usually thought to be caused by dehydration and fluid loss. Thrombotic microangiopathy (TMA) is an uncommon aggravation of dengue fever and chikungunya, with only a few cases described in the medical literature. The aim of this study is to present 3 cases of TMA associated with arboviral infection. Three patients with clinical history, laboratory test, and kidney biopsy results compatible with TMA were selected for the study, 2 of whom had a serological diagnosis of dengue fever and 1 of chikungunya. The 3 patients were followed up at the Federal University of Maranhão Hospital’s Nephrology Service in 2018. A targeted gene panel sequencing (TGPS) plus multiple to atypical hemolytic uremic syndrome (aHUS) multiplex ligation–dependent probe amplification (MLPA) was performed in 2 of the patients and revealed in the patient 1 a heterozygous pathogenic variant in the gene THBD, as well as heterozygous deletions in CFH, CFHR1, and CFHR3. In the patient 2, there were heterozygous pathogenic variant in the genes CFI and CFB, in addition to heterozygous deletions in the genes CFHR1 and CFHR3. Both received treatment with eculizumab and undergone recovery of renal function. The third patient had TMA not classified as either aHUS or thrombotic thrombocytopenic purpura (TTP); he abandoned the treatment and returned to the service after 2 years for a dialysis emergency. Patients with arboviral infectious disease and changes that suggest TMA should have appropriate support to establish early diagnosis and useful treatment.

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Section: Case Discussionmentioning

confidence: 99%