Frontiers in Pharmacology (Feb 2022)

Case Report: Tackling Complement Hyperactivation With Eculizumab in Atypical Hemolytic Uremic Syndrome Triggered by COVID-19

  • Valentina Fanny Leone,
  • Amantia Imeraj,
  • Sara Gastoldi,
  • Caterina Mele,
  • Lucia Liguori,
  • Carmelita Condemi,
  • Piero Ruggenenti,
  • Giuseppe Remuzzi,
  • Camillo Carrara

DOI
https://doi.org/10.3389/fphar.2022.842473
Journal volume & issue
Vol. 13

Abstract

Read online

Hemolytic uremic syndrome (HUS) is a rare life-threatening disease of unrestrained complement system dysregulation, microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure in genetically predisposed individuals. In this report, we describe two cases of SARS-CoV-2–associated HUS treated with eculizumab, a C5-blocking monoclonal antibody reported to be remarkably effective in the treatment of HUS. Detailed biochemical and genetic complement system analysis is reported, and the prompt clinical response after C5 pharmacological blockade is documented. Our report provides the rationale and supports the use of terminal complement pathway inhibition for the treatment of SARS-CoV-2–associated HUS.

Keywords