Division of Nephrology, Toronto General Hospital, University of Toronto , Toronto, Ontario , Canada and.
Ren Fail. 2014 May;36(4):631-3. doi: 10.3109/0886022X.2014.882712. Epub 2014 Feb 10.
The complement system plays a vital role in preventing life-threatening infections by ensuring optimal functioning of the host immune system. Its dysregulation has been implicated in causing glomerular, hematological, and transplant-related disorders. Eculizumab a novel monoclonal antibody against complement component C5 has emerged in the recent past as the standard of care offering an effective rescue and maintenance therapy against many of these disorders. Its use has been associated with increased risk of infections predominantly with encapsulated organisms. There is no data in the literature on its effects in end-stage kidney disease (ESKD) or dialysis patients. We describe here a very rare case of Aspergillus Niger peritonitis in an ESKD patient on peritoneal dialysis (PD) receiving maintenance eculizumab therapy for atypical hemolytic uremic syndrome. Given that murine models with the same defect as that induced by eculizumab is vulnerable to invasive Aspergillosis, it is suggested that the fungal peritonitis in this patient was the result of the eculizumab therapy.
补体系统在预防危及生命的感染方面起着至关重要的作用，它可以确保宿主免疫系统的最佳功能。其失调与肾小球、血液和移植相关疾病的发生有关。依库珠单抗是一种新型的针对补体成分 C5 的单克隆抗体，最近已成为治疗这些疾病的标准治疗方法，提供了有效的抢救和维持治疗。其使用与感染风险增加有关，主要是与囊状生物体有关。目前文献中尚无关于其在终末期肾病（ESKD）或透析患者中的作用的数据。我们在这里描述了一例非常罕见的黑曲霉腹膜炎病例，该患者为接受依库珠单抗维持治疗非典型溶血尿毒综合征的腹膜透析（PD）患者。鉴于与依库珠单抗诱导的相同缺陷的小鼠模型易发生侵袭性曲霉病，因此推测该患者的真菌性腹膜炎是依库珠单抗治疗的结果。
