Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab

Hemolytic Uremic Syndrome (HUS) is a constellation of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Shiga toxin-producing Escherichia coli- (STEC-) mediated HUS is a common cause of acute renal failure in children and can rarely result in severe neurological complicat...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jacob H. Umscheid, Collin Nevil, Rhythm Vasudeva, Mohammed Farhan Ali, Nisha Agasthya
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/029f5c3b98274989aad0596628eb3c76
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:029f5c3b98274989aad0596628eb3c76
record_format	dspace
spelling	oai:doaj.org-article:029f5c3b98274989aad0596628eb3c762021-11-22T01:10:29ZTreatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab2090-681110.1155/2021/8053246https://doaj.org/article/029f5c3b98274989aad0596628eb3c762021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/8053246https://doaj.org/toc/2090-6811Hemolytic Uremic Syndrome (HUS) is a constellation of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Shiga toxin-producing Escherichia coli- (STEC-) mediated HUS is a common cause of acute renal failure in children and can rarely result in severe neurological complications such as encephalopathy, seizures, cerebrovascular accidents, and coma. Current literature supports use of eculizumab, a monoclonal antibody that blocks complement activation, in atypical HUS (aHUS). However, those with neurologic complications from STEC-HUS have complement activation and deposition of aggregates in microvasculature and may be treated with eculizumab. In this case report, we describe a 3-year-old boy with diarrhea-positive STEC-HUS who developed severe neurologic involvement in addition to acute renal failure requiring renal replacement therapy. He was initiated on eculizumab therapy, with clinical improvement and organ recovery. This case highlights systemic complications of STEC-HUS in a pediatric patient. The current literature is limited but has suggested a role for complement mediation in cases with severe complications. We review the importance of early recognition of complications, use of eculizumab, and current data available.Jacob H. UmscheidCollin NevilRhythm VasudevaMohammed Farhan AliNisha AgasthyaHindawi LimitedarticlePediatricsRJ1-570ENCase Reports in Pediatrics, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pediatrics RJ1-570
spellingShingle	Pediatrics RJ1-570 Jacob H. Umscheid Collin Nevil Rhythm Vasudeva Mohammed Farhan Ali Nisha Agasthya Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab
description	Hemolytic Uremic Syndrome (HUS) is a constellation of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Shiga toxin-producing Escherichia coli- (STEC-) mediated HUS is a common cause of acute renal failure in children and can rarely result in severe neurological complications such as encephalopathy, seizures, cerebrovascular accidents, and coma. Current literature supports use of eculizumab, a monoclonal antibody that blocks complement activation, in atypical HUS (aHUS). However, those with neurologic complications from STEC-HUS have complement activation and deposition of aggregates in microvasculature and may be treated with eculizumab. In this case report, we describe a 3-year-old boy with diarrhea-positive STEC-HUS who developed severe neurologic involvement in addition to acute renal failure requiring renal replacement therapy. He was initiated on eculizumab therapy, with clinical improvement and organ recovery. This case highlights systemic complications of STEC-HUS in a pediatric patient. The current literature is limited but has suggested a role for complement mediation in cases with severe complications. We review the importance of early recognition of complications, use of eculizumab, and current data available.
format	article
author	Jacob H. Umscheid Collin Nevil Rhythm Vasudeva Mohammed Farhan Ali Nisha Agasthya
author_facet	Jacob H. Umscheid Collin Nevil Rhythm Vasudeva Mohammed Farhan Ali Nisha Agasthya
author_sort	Jacob H. Umscheid
title	Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab
title_short	Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab
title_full	Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab
title_fullStr	Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab
title_full_unstemmed	Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab
title_sort	treatment of shiga-toxin hus with severe neurologic features with eculizumab
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/029f5c3b98274989aad0596628eb3c76
work_keys_str_mv	AT jacobhumscheid treatmentofshigatoxinhuswithsevereneurologicfeatureswitheculizumab AT collinnevil treatmentofshigatoxinhuswithsevereneurologicfeatureswitheculizumab AT rhythmvasudeva treatmentofshigatoxinhuswithsevereneurologicfeatureswitheculizumab AT mohammedfarhanali treatmentofshigatoxinhuswithsevereneurologicfeatureswitheculizumab AT nishaagasthya treatmentofshigatoxinhuswithsevereneurologicfeatureswitheculizumab
_version_	1718418320074473472

Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab

Ejemplares similares