Wei Xin, Liu Xinzhu, Yu Yingying, Xie Wei, Luo Wentao, Tu Ye, Bu Shuhong, Guo Guimei
Department of Clinical Pharmacy, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Pediatric Intensive Care Unit, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Pediatr. 2024 Jul 31;12:1404725. doi: 10.3389/fped.2024.1404725. eCollection 2024.
Eculizumab, a recombined humanized monoclonal antibody which possesses high affinity for the complement protein C5, is a therapeutic agent utilized in the treatment of atypical hemolytic uremic syndrome (aHUS) by inhibiting the terminal complement complex C5b-9. In a pediatric patient with aHUS of 14 months, the administration of eculizumab therapy was accompanied by the inclusion of meningococcal vaccine as part of the national immunization program. Notably, no other antibiotics were administered prior to or during the course of eculizumab treatment. Moreover, there were no occurrences of infusion reactions or meningococcal infections observed throughout the course of treatment. Due to the presence of anti-factor H antibodies and insufficient recovery, glucocorticoids and eculizumab were administered at week 0 and week 1, followed by the initiation of mycophenolate mofetil (MMF) at a dosage of 250 mg (approximately 548 mg/m) per day starting from Day 10. Due to the recovered of complement antibody after 8 doses of eculizumab, the therapeutic interval was extended from once every 3 weeks to once a month since 9th administration. We experienced and successfully treated a rare case of aHUS with eculizumab in a 14-month-old Chinese pediatric patient.
依库珠单抗是一种对补体蛋白C5具有高亲和力的重组人源化单克隆抗体,是一种通过抑制末端补体复合物C5b-9来治疗非典型溶血性尿毒症综合征(aHUS)的治疗药物。在一名14个月大的aHUS儿科患者中,依库珠单抗治疗的同时按照国家免疫规划纳入了脑膜炎球菌疫苗。值得注意的是,在依库珠单抗治疗之前或治疗期间未使用其他抗生素。此外,在整个治疗过程中未观察到输液反应或脑膜炎球菌感染的发生。由于存在抗因子H抗体且恢复不足,在第0周和第1周给予糖皮质激素和依库珠单抗,随后从第10天开始以每天250 mg(约548 mg/m)的剂量开始使用霉酚酸酯(MMF)。由于在8剂依库珠单抗后补体抗体恢复,自第9次给药起治疗间隔从每3周一次延长至每月一次。我们成功治疗了一名14个月大的中国儿科aHUS罕见病例。