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依库珠单抗成功治疗与感染相关的非典型溶血性尿毒症综合征。

Atypical Haemolytic Uraemic Syndrome Associated with Infection Successfully Treated with Eculizumab.

作者信息

Inglis Joshua M, Barbara Jeffrey A, Juneja Rajiv, Milton Caroline, Passaris George, Li Jordan Y Z

机构信息

Department of General Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.

Department of Renal Medicine, Flinders Medical Centre, Adelaide, SA, Australia.

出版信息

Case Rep Nephrol. 2018 May 10;2018:1759138. doi: 10.1155/2018/1759138. eCollection 2018.

Abstract

infection is a rare precipitant of atypical haemolytic uraemic syndrome (aHUS). A 46-year-old man presented with watery diarrhoea following an ileocaecal resection. He developed an acute kidney injury with anaemia, thrombocytopaenia, raised lactate dehydrogenase, low haptoglobin, and red cell fragments. Stool sample was positive for toxin B. He became dialysis-dependent as his renal function continued to worsen despite treatment with empiric antibiotics and plasma exchange. The ADAMTS13 level was normal consistent with a diagnosis of aHUS. The commencement of eculizumab led to the resolution of haemolysis and stabilisation of haemoglobin and platelets with an improvement in renal function.

摘要

感染是不典型溶血尿毒综合征(aHUS)的罕见诱因。一名46岁男性在回盲部切除术后出现水样腹泻。他发展为急性肾损伤,伴有贫血、血小板减少、乳酸脱氢酶升高、触珠蛋白降低和红细胞碎片。粪便样本毒素B检测呈阳性。尽管接受了经验性抗生素治疗和血浆置换,但随着肾功能持续恶化,他开始依赖透析。ADAMTS13水平正常,符合aHUS的诊断。使用依库珠单抗后溶血得到缓解,血红蛋白和血小板稳定,肾功能有所改善。

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本文引用的文献

1
Management of hemolytic uremic syndrome.溶血尿毒综合征的管理
F1000Prime Rep. 2014 Dec 1;6:119. doi: 10.12703/P6-119. eCollection 2014.
2
Hemolytic uremic syndrome and Clostridium difficile colitis.溶血性尿毒症综合征和艰难梭菌结肠炎。
J Community Hosp Intern Med Perspect. 2012 Oct 15;2(3). doi: 10.3402/jchimp.v2i3.19064. Print 2012.
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Atypical hemolytic-uremic syndrome.非典型溶血尿毒综合征
N Engl J Med. 2009 Oct 22;361(17):1676-87. doi: 10.1056/NEJMra0902814.
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Atypical haemolytic uraemic syndrome.非典型溶血性尿毒症综合征
Br Med Bull. 2006;77-78:5-22. doi: 10.1093/bmb/ldl004. Epub 2006 Sep 11.

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