Case Report: Tackling Complement Hyperactivation With Eculizumab in Atypical Hemolytic Uremic Syndrome Triggered by COVID-19
Valentina Fanny Leone(Ospedale Papa Giovanni XXIII), Amantia Imeraj(Mario Negri Institute for Pharmacological Research), Sara Gastoldi(Mario Negri Institute for Pharmacological Research), Caterina Mele(Mario Negri Institute for Pharmacological Research), Lucia Liguori(Mario Negri Institute for Pharmacological Research), Carmelita Condemi(Ospedale Papa Giovanni XXIII), Piero Ruggenenti(Ospedale Papa Giovanni XXIII), Giuseppe Remuzzi(Mario Negri Institute for Pharmacological Research), Camillo Carrara(Ospedale Papa Giovanni XXIII)
Cited by 10Open Access
Abstract
Hemolytic uremic syndrome (HUS) is a rare life-threatening disease of unrestrained complement system dysregulation, microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure in genetically predisposed individuals. In this report, we describe two cases of SARS-CoV-2-associated HUS treated with eculizumab, a C5-blocking monoclonal antibody reported to be remarkably effective in the treatment of HUS. Detailed biochemical and genetic complement system analysis is reported, and the prompt clinical response after C5 pharmacological blockade is documented. Our report provides the rationale and supports the use of terminal complement pathway inhibition for the treatment of SARS-CoV-2-associated HUS.