Long-term renal function under plasma exchange in atypical hemolytic uremic syndrome
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jean-Claude Davin & Jaap Groothoff & Valentina Gracchi & Antonia Bouts
- چاپ و سال / کشور: 2011
Description
In a paper byWaters and Licht published recently in Pediatric Nephrology, eculizumab is presented as the emerging drug to replace plasma exchange (PE) to treat and prevent atypical hemolytic uremic syndrome (aHUS) [1], allowing complications possibly associated with chronic PE use related to arteriovenous fistula and infusion of blood products (viral infections, allergic reaction) to be avoided. Eculizumab is an anti-C5 monoclonal humanized mouse antibody that binds to C5 and prevents the action of C5 convertase that splits C5 in C5a and C5b, impeding formation of the C5b-9 membraneattack complex (or MAC) that binds to and permeabilizes cell membranes, thereby killing microorganisms but also damaging host endothelial cells, as in aHUS. Eculizumab treatment has been shown to be successful in several reported aHUS cases. However, the use of this drug over the long term is limited by extremely high cost, possible infectious complications by Neisseria, and by fetal morbidity in case of administration during pregnancy. Although it has not yet been demonstrated, the possibility of developing antieculizumab antibodies cannot be excluded.
Pediatr Nephrol DOI 10.1007/s00467-011-1925-7 Received: 10 March 2011 / Accepted: 21 April 2011
