title: Eculizumab for atypical hemolytic uremic syndrome in pregnancy.
abstract: BACKGROUND
  Atypical hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy often caused by mutations in complement genes. During pregnancy, disease outcome is poor both for mother and fetus. Since 2009, the humanized monoclonal antibody eculizumab has been successfully used in the treatment of atypical HUS in nonpregnant patients.
  
  
  METHODS
  A 26-year-old woman with a homozygous mutation in complement factor H developed a relapse of atypical HUS at 17 weeks of gestation in her first pregnancy. Because the disease remained active despite multiple plasma exchanges, eculizumab was started at 26 weeks of gestation. It was well tolerated and has led to remission and to the delivery of a healthy neonate.
  
  
  CONCLUSIONS
  Eculizumab may be useful for the treatment of atypical HUS during pregnancy.
authors.affiliation: Center for HUS Control, Prevention and Management, the Obstetrics and Gynecology Department and the Internal Medicine, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan and Ospedale Infermi, Rimini, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Ardissino
authors.forename: Manuela
authors.initials: M
authors.lastname: Wally Ossola
authors.forename: Giulia
authors.initials: G
authors.lastname: Maria Baffero
authors.forename: Angelo
authors.initials: A
authors.lastname: Rigotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Cugno
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D065766:Atypical Hemolytic Uremic Syndrome; D017242:Complement Factor H / Q000235:genetics; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000188:drug therapy* / Q000235:genetics; D006720:Homozygote; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D017242:Complement Factor H; C481642:eculizumab