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非典型溶血性尿毒症综合征

Atypical Hemolytic Uremic Syndrome.

作者信息

Dixon Bradley P, Gruppo Ralph A

机构信息

Renal Section, Department of Pediatrics, University of Colorado School of Medicine, 13123 East 16th Avenue, Aurora, CO 80045, USA.

Division of Hematology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.

出版信息

Pediatr Clin North Am. 2018 Jun;65(3):509-525. doi: 10.1016/j.pcl.2018.02.003.

Abstract

Atypical hemolytic uremic syndrome is a rare life-threatening disease of unregulated complement activation. Untreated, the prognosis is generally poor; more than one-half of patients die or develop end-stage renal disease within 1 year. Atypical hemolytic uremic syndrome is characterized by thrombotic microangiopathy with evidence of hemolysis, thrombocytopenia, and renal impairment. This systemic disease affects the kidneys, brain, heart, lungs, gastrointestinal tract, pancreas, and skin. Acquired and genetic abnormalities of complement regulation may be identified in approximately 70% of patients. Plasma therapy is generally ineffective. Eculizumab blocks terminal complement activation, prevents complement-mediated organ damage, and is currently recommended as front-line therapy.

摘要

非典型溶血性尿毒症综合征是一种罕见的、因补体激活失控而危及生命的疾病。若不治疗,预后通常较差;超过一半的患者会在1年内死亡或发展为终末期肾病。非典型溶血性尿毒症综合征的特征为血栓性微血管病,并伴有溶血、血小板减少和肾功能损害的证据。这种全身性疾病会影响肾脏、大脑、心脏、肺、胃肠道、胰腺和皮肤。约70%的患者可发现补体调节的获得性和遗传性异常。血浆治疗通常无效。依库珠单抗可阻断补体末端激活,防止补体介导的器官损伤,目前被推荐作为一线治疗药物。

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