Suzuki Kazutaka, Nagaharu Keiki, Hachiya Kensuke, Nishimura Komei, Matsumoto Takeshi, Tawara Isao
Department of Hematology and Oncology, Mie University Hospital.
Department of Transfusion Medicine and Cell Therapy, Mie University Hospital.
Rinsho Ketsueki. 2022;63(3):224-228. doi: 10.11406/rinketsu.63.224.
Atypical hemolytic uremic syndrome (aHUS) is a lethal disease resulting in systemic thrombotic microangiopathies due to complement dysregulation. Immune activation by viral infections, such as SARS-CoV-2, may trigger hemolytic attack. A 38-year-old man, who had been previously diagnosed with aHUS due to complement component 3 mutation, was proven to be positive for SARS-CoV-2 without respiratory symptoms. No specific intervention was given to the patient, and he developed hematuria and oliguria three days after diagnosis. The patient was subsequently referred to our hospital and treated with eculizumab (900 mg). Afterward, the hemolytic symptoms improved rapidly. To the best of our knowledge, there have been reports of at least ten cases of hemolysis triggered by COVID-19 in patients with aHUS, and a potential clinical benefit of eculizumab for hemolytic attack, as well as for COVID-19, has been suggested. Here, we report the findings of a case, which indicate the efficacy of eculizumab introduction at an early stage.
非典型溶血性尿毒症综合征（aHUS）是一种由于补体失调导致系统性血栓性微血管病的致命疾病。病毒感染（如SARS-CoV-2）引起的免疫激活可能引发溶血发作。一名38岁男性，此前因补体成分3突变被诊断为aHUS，经检测SARS-CoV-2呈阳性，但无呼吸道症状。未对该患者进行特殊干预，诊断三天后他出现血尿和少尿。随后该患者被转诊至我院，接受了依库珠单抗（900毫克）治疗。此后，溶血症状迅速改善。据我们所知，已有至少十例关于COVID-19引发aHUS患者溶血的报道，并且有人提出依库珠单抗对溶血发作以及对COVID-19可能具有临床益处。在此，我们报告一例病例的研究结果，表明早期使用依库珠单抗的疗效。
