Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation
Atypical haemolytic uraemic syndrome is a disease caused by complement regulation abnormalities that generally progresses to chronic end-stage renal disease with a high rate of recurrence in kidney transplantation and a high risk of graft loss. Anti-complement therapy has improved the prognosis of t...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-07-01
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| Series: | Nefrología (English Edition) |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S201325141830066X |
| _version_ | 1818067693429850112 |
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| author | John Fredy Nieto-Ríos Mónica Zuluaga-Quintero Diana Carolina Bello-Márquez Arbey Aristizabal-Alzate Catalina Ocampo-Kohn Lina María Serna-Higuita Lina Arias Gustavo Zuluaga-Valencia |
| author_facet | John Fredy Nieto-Ríos Mónica Zuluaga-Quintero Diana Carolina Bello-Márquez Arbey Aristizabal-Alzate Catalina Ocampo-Kohn Lina María Serna-Higuita Lina Arias Gustavo Zuluaga-Valencia |
| author_sort | John Fredy Nieto-Ríos |
| collection | DOAJ |
| description | Atypical haemolytic uraemic syndrome is a disease caused by complement regulation abnormalities that generally progresses to chronic end-stage renal disease with a high rate of recurrence in kidney transplantation and a high risk of graft loss. Anti-complement therapy has improved the prognosis of these patients, achieving disease remission in most cases, increasing the likelihood of a successful kidney transplant and increasing patient and graft survival. Drugs with low risk of induction of thrombotic microangiopathies such as belatacept and mycophenolate have also been used with satisfactory results. We present the case of a young patient at high immunological risk, with atypical haemolytic uraemic syndrome due to factor H mutation, who underwent a successful kidney transplantation with eculizumab, thymoglobulin, belatacept, mycophenolate and steroids, to date preserving excellent graft function without disease recurrence. Resumen: El síndrome hemolítico urémico atípico es una enfermedad relacionada con alteración en la regulación del complemento que generalmente evoluciona a enfermedad renal crónica terminal, con alta tasa de recaída en el trasplante renal y elevado riesgo de pérdida del injerto. La terapia anticomplemento ha mejorado el pronóstico de estos pacientes, logrando tener remisión de la enfermedad en la mayoría de los casos, aumentando la posibilidad de un trasplante renal exitoso e incrementando la supervivencia del paciente y del injerto; igualmente el uso de medicamentos con bajo riesgo de inducción de microangiopatías trombóticas como el belatacept y micofenolato se han utilizado con resultados satisfactorios. Presentamos el caso de una paciente joven de alto riesgo inmunológico, con síndrome hemolítico urémico atípico por mutación del factor H, a quien se realizó trasplante renal exitoso con eculizumab, timoglobulina, belatacept, micofenolato y esteroides conservando excelente función del injerto y sin recaídas de su enfermedad. Keywords: Atypical haemolytic uraemic syndrome, Thrombotic microangiopathies, Kidney transplantation, Eculizumab, Belatacept, Palabras clave: Síndrome hemolítico urémico atípico, Microangiopatías trombóticas, Trasplante de riñón, Eculizumab, Belatacept |
| first_indexed | 2024-12-10T15:27:44Z |
| format | Article |
| id | doaj.art-8996f0a1fd7f44c7b90c941895e3262f |
| institution | Directory Open Access Journal |
| issn | 2013-2514 |
| language | English |
| last_indexed | 2024-12-10T15:27:44Z |
| publishDate | 2018-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Nefrología (English Edition) |
| spelling | doaj.art-8996f0a1fd7f44c7b90c941895e3262f2022-12-22T01:43:29ZengElsevierNefrología (English Edition)2013-25142018-07-01384433437Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutationJohn Fredy Nieto-Ríos0Mónica Zuluaga-Quintero1Diana Carolina Bello-Márquez2Arbey Aristizabal-Alzate3Catalina Ocampo-Kohn4Lina María Serna-Higuita5Lina Arias6Gustavo Zuluaga-Valencia7Departamento de Nefrología y Trasplante Renal, Hospital Pablo Tobón Uribe, Medellín, Colombia; Departamento de Medicina Interna y Nefrología, Universidad de Antioquia, Medellín, Colombia; Corresponding author.Departamento de Medicina Interna, Hospital Pablo Tobón Uribe, Medellín, ColombiaDepartamento de Nefrología, Centro Urogine, Medellín, ColombiaDepartamento de Nefrología y Trasplante Renal, Hospital Pablo Tobón Uribe, Medellín, ColombiaDepartamento de Nefrología y Trasplante Renal, Hospital Pablo Tobón Uribe, Medellín, Colombia; Departamento de Medicina Interna y Nefrología, Universidad de Antioquia, Medellín, ColombiaInstituto de Bioestadística y Epidemiología Clínica, Hospital Universitario de Tübingen, Tübingen, GermanyDepartamento de Medicina Interna y Nefrología, Universidad de Antioquia, Medellín, ColombiaDepartamento de Nefrología y Trasplante Renal, Hospital Pablo Tobón Uribe, Medellín, ColombiaAtypical haemolytic uraemic syndrome is a disease caused by complement regulation abnormalities that generally progresses to chronic end-stage renal disease with a high rate of recurrence in kidney transplantation and a high risk of graft loss. Anti-complement therapy has improved the prognosis of these patients, achieving disease remission in most cases, increasing the likelihood of a successful kidney transplant and increasing patient and graft survival. Drugs with low risk of induction of thrombotic microangiopathies such as belatacept and mycophenolate have also been used with satisfactory results. We present the case of a young patient at high immunological risk, with atypical haemolytic uraemic syndrome due to factor H mutation, who underwent a successful kidney transplantation with eculizumab, thymoglobulin, belatacept, mycophenolate and steroids, to date preserving excellent graft function without disease recurrence. Resumen: El síndrome hemolítico urémico atípico es una enfermedad relacionada con alteración en la regulación del complemento que generalmente evoluciona a enfermedad renal crónica terminal, con alta tasa de recaída en el trasplante renal y elevado riesgo de pérdida del injerto. La terapia anticomplemento ha mejorado el pronóstico de estos pacientes, logrando tener remisión de la enfermedad en la mayoría de los casos, aumentando la posibilidad de un trasplante renal exitoso e incrementando la supervivencia del paciente y del injerto; igualmente el uso de medicamentos con bajo riesgo de inducción de microangiopatías trombóticas como el belatacept y micofenolato se han utilizado con resultados satisfactorios. Presentamos el caso de una paciente joven de alto riesgo inmunológico, con síndrome hemolítico urémico atípico por mutación del factor H, a quien se realizó trasplante renal exitoso con eculizumab, timoglobulina, belatacept, micofenolato y esteroides conservando excelente función del injerto y sin recaídas de su enfermedad. Keywords: Atypical haemolytic uraemic syndrome, Thrombotic microangiopathies, Kidney transplantation, Eculizumab, Belatacept, Palabras clave: Síndrome hemolítico urémico atípico, Microangiopatías trombóticas, Trasplante de riñón, Eculizumab, Belatacepthttp://www.sciencedirect.com/science/article/pii/S201325141830066X |
| spellingShingle | John Fredy Nieto-Ríos Mónica Zuluaga-Quintero Diana Carolina Bello-Márquez Arbey Aristizabal-Alzate Catalina Ocampo-Kohn Lina María Serna-Higuita Lina Arias Gustavo Zuluaga-Valencia Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation Nefrología (English Edition) |
| title | Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation |
| title_full | Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation |
| title_fullStr | Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation |
| title_full_unstemmed | Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation |
| title_short | Successful kidney transplant with eculizumab, thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor H mutation |
| title_sort | successful kidney transplant with eculizumab thymoglobulin and belatacept therapy in a highly sensitised patient with atypical haemolytic uraemic syndrome due to factor h mutation |
| url | http://www.sciencedirect.com/science/article/pii/S201325141830066X |
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