title: Successful management of obstructive jaundice due to gallstones with eculizumab in a patient with paroxysmal nocturnal hemoglobinuria.
abstract: Paroxysmal nocturnal hemoglobinuria (PNH) makes patients susceptible to intravascular hemolysis and thrombosis, and it can be life-threatening in stressful situations. Eculizumab, a humanized monoclonal antibody that inhibits the complement protein C5, has been evaluated as a novel therapy for PNH. We herein describe the case of a 59-year-old Japanese woman with classic PNH, who had been successfully treated with eculizumab, but who later developed acute cholecystitis/cholangitis from gallstones. Although the severe obstructive jaundice requiring endoscopic therapy following cholecystectomy was complicated, critical intravascular hemolysis and thrombosis were not observed. Therefore, utilizing eculizumab during the peri-operative management of PNH patients should be carefully taken into consideration.
authors.affiliation: Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawano
authors.forename: Kentaro
authors.initials: K
authors.lastname: Minagawa
authors.forename: Kanako
authors.initials: K
authors.lastname: Wakahashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kawano
authors.forename: Akiko
authors.initials: A
authors.lastname: Sada
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Matsui
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Hirano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shiomi
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002763:Cholecystectomy; D019468:Disease Management; D004724:Endoscopy; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000601:surgery*; D006457:Hemoglobinuria, Paroxysmal / Q000188:drug therapy*; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D059035:Perioperative Period
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C481642:eculizumab