Eculizumab as a rescue therapy in a kidney transplant recipient with atypical Hemolytic Uremic Syndrome: A case reportopen access
- Authors
- Oh, Young Ju; Lee, Joo Hyun; Kim, Yeonmi; Jun, Heungman; Sim, Jong Min; Kim, Myung Gyu; Jung, Cheol Woong
- Issue Date
- Dec-2022
- Publisher
- Korean Society for Transplantation
- Keywords
- Atypical hemolytic uremic syndrome; Eculizumab; Kidney transplantation; Case report
- Citation
- Korean Journal of Transplantation, v.36, no.4, pp 283 - 288
- Pages
- 6
- Indexed
- SCOPUS
KCI
- Journal Title
- Korean Journal of Transplantation
- Volume
- 36
- Number
- 4
- Start Page
- 283
- End Page
- 288
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62789
- DOI
- 10.4285/kjt.22.0027
- ISSN
- 2671-8804
- Abstract
- A 61-year-old female patient with chronic kidney disease due to diabetes mellitus and hypertension–induced nephropathy received a deceased donor kidney transplant in March 2020. In July 2020, she was transferred from a local hospital due to the exacerbation of general weakness and diarrhea. Upon her arrival, we noticed a high level of serum creatinine (sCr) of 1.5 mg/dL and a decrease in urine output. Her laboratory results indicated significant hemolysis, with a hemoglobin level of 7.0 g/dL, platelet count of 20 ×103/μL, and a lactate dehydrogenase level of 3,207 IU/L. Kidney biopsy showed severe thrombotic microangiopathy without any evidence of acute rejection. Under the impression of atypical hemolytic uremic syndrome (aHUS), we immediately started plasmapheresis and hemodialysis for anuria. Eculizumab was considered as a kidney graft rescue therapy since her sCr level was not effectively decreased, and her anuria continued despite hemodialysis and plasmapheresis. Eculizumab (900 mg) was administered weekly for 4 weeks. An additional 600 mg of eculizumab was administered on the day of plasmapheresis. Since the patient’s laboratory data gradually improved, hemodialysis and plasmapheresis were ceased on admission day 37. After that, eculizumab was administered biweekly (1,200 mg) two more times. The patient’s sCr and platelet count normalized after 2 months of eculizumab treatment. Based on our experience, a shorter interval between the clinical diagnosis of aHUS and administration of eculizumab increases the likelihood of rescuing the kidney.
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Collections - 2. Clinical Science > Department of Nephrology and Hypertension > 1. Journal Articles
- 2. Clinical Science > Department of Pathology > 1. Journal Articles
- 2. Clinical Science > Department of Hepato-Biliary-Pancreatic Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Transplantation and Vascular Surgery > 1. Journal Articles
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