[Use of Eculizumab in atypical hemolytic uremic syndrome after renal transplantation].
To report the use of Eculizumab in atypical hemolytic uremic syndrome (aHUS) after renal transplantation. A 16 year-old patient diagnosed with chronic kidney disease since 2010, due to aHUS, under dialysis. kidney transplantation by deceased donor: February/2012. She showed good clinical evolution until the 14th postoperative day, when he developed a fever, oliguria, worsening of renal function [serum creatinine (CRs): 4.0 mg/dl] and signs of hemolysis [platelets: 110,000 mm3; hemoglobin (Hb): 4.5 g/dL; LDH: 3366 U/L]. Renal biopsy of the graft: thrombotic microangiopathy. Treated with handling blood products (fresh plasma) and plasmapheresis, with improvement of renal function (serum creatinine: 1.46 mg/dl). A week after this complication, fever anemia, signs of hemolysis and ITU restarted then it was handled with ciprofloxacin, methylprednisolone pulse therapy and plasma transfusion (Platelets: 43,000 mm3; Hb: 6.0 mg/dl, reticulocytes; 1.3%, haptoglobin < 5.8 mg/dl, HDL: 1181 U/L). After clinical worsening, it was started a therapy with Eculizumab, 900 mg in every five days for two weeks. There was some progress with good clinical response, characterized by improved renal function, stabilization of aHUS and discharged in five days. Since then, she keeps using Eculizumab 900 mg each 15 days with the renal and haematological normalization (Platelets: 160,000 mm3; Hb: 11.4 g/dL). The use of Eculizumab was useful in controlling the ongoing manifestation of aHUS and transplant preservation.
Faculdades Unidas do Norte de Minas, Brasil.
Claudia Iglesias
CI
Teixeira
Faculdades Unidas do Norte de Minas, Brasil.
Roberta Gonçalves
RG
Mota
Faculdades Unidas do Norte de Minas, Brasil.
Bruna Gabriela Vieira
BG
Afonso
Faculdades Unidas do Norte de Minas, Brasil.
Tatiana Vieira
TV
Carneiro
Faculdades Unidas do Norte de Minas, Brasil.
Geraldo Sérgio Gonçalves
GS
Meira
Faculdades Unidas do Norte de Minas, Brasil.
Divino Urias
DU
Mendonça
D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D065766:Atypical Hemolytic Uremic Syndrome / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000188:drug therapy*
D061067:Antibodies, Monoclonal, Humanized; C481642:eculizumab