title: Thrombotic microangiopathy and human immunodeficiency virus in the era of eculizumab.
abstract: Thrombotic microangiopathies (TMAs) include thrombotic thromobocytopenic purpura and hemolytic uremic syndrome (HUS). Among these conditions, atypical HUS is now recognized to be a disease of alternative complement pathway dysregulation. Eculizumab is a recombinant humanized monoclonal antibody that binds to the complement protein C5 and prevents the cleavage of C5 to C5a and C5b. Eculizumab has been used as a novel treatment for complement-mediated TMA. We present a case of a patient with human immunodeficiency virus infection who developed TMA and was successfully treated with eculizumab. The effect of long-term treatment with this new medication is unknown, and further studies are needed to establish guidelines in the management of this condition.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of California Irvine, Orange, CA, USA; Nephrology Section, Department of Medicine, Long Beach Veteran Affairs Health System, Long Beach, CA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Jin
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of California Irvine, Orange, CA, USA; Nephrology Section, Department of Medicine, Long Beach Veteran Affairs Health System, Long Beach, CA, USA.
authors.forename: Laleh
authors.initials: L
authors.lastname: Boroujerdi-Rad
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of California Irvine, Orange, CA, USA; Nephrology Section, Department of Medicine, Long Beach Veteran Affairs Health System, Long Beach, CA, USA.
authors.forename: Gaurang
authors.initials: G
authors.lastname: Shah
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of California Irvine, Orange, CA, USA; Nephrology Section, Department of Medicine, Long Beach Veteran Affairs Health System, Long Beach, CA, USA.
authors.forename: Joline L T
authors.initials: JL
authors.lastname: Chen
keywords: HIV; complement; intensive care; plasma exchange; thrombotic microangiopathy