A Case of Carfilzomib-Induced Atypical Hemolytic Uremic Syndrome

Abstract

Atypical hemolytic uremic syndrome (aHUS) is a rare non-Shiga toxin thrombotic microangiopathy caused by uncontrolled activation of the alternative complement pathway. We present a 43-year-old man with a history of multiple myeloma receiving carfilzomib presenting with acute vomiting, diarrhea, and anuria. Laboratory results showed anemia, thrombocytopenia, and kidney failure. Additional evaluation led to a diagnosis of carfilzomib-induced thrombotic microangiopathy. Carfilzomib was withdrawn and ravulizumab was started, with improvements in platelet count and kidney function. Atypical hemolytic uremic syndrome is a rare adverse effect of carfilzomib and requires a high index of suspicion to ensure timely diagnosis and treatment.