Table 1. Reported cases of eculizumab treatment in children < 10 kg with atypical hemolytic uremic syndrome.
| Reference | Patient age at presentation | Eculizumab dosing | Antibiotic prophylaxis | Immunizations | Most recent follow-up |
|---|---|---|---|---|---|
| Patient weight < 5 kg | |||||
| Michaux et al . [1] | 11 days (unclear which day drug started) | 300 mg weekly for 2 doses then, every 2 weeks for 2 months then, every 3 weeks | Penicillin VK until vaccination | Meningococcal vaccine* given at 6 months of age | At 27 months old, normal renal function, no proteinuria, normal blood pressure |
| Ariceta et al. [5] | 28 days (39 days old when started eculizumab) | 300 mg for 1 dose then, 150 mg for 1 dose (relapse) then, 300 mg every 3 weeks | Amoxicillin (duration NR) | Meningococcal vaccine* before eculizumab | At 14 months old, normal renal function, proteinuria (urine protein/creatinine ratio 1 mg/g), normal blood pressure |
| Current case | 28 days (35 days old when started eculizumab) | 300 mg weekly for 2 doses then, every 3 weeks | Ampicillin then penicillin VK ongoing | Pneumococcal-13 conjugate, meningococcal CY polysaccharide, and Haemophilus b tetanus toxoid within 24 hours of eculizumab | At 12 months old, normal renal function, no proteinuria, normal blood pressure |
| Patient weight 5 – 10 kg | |||||
| Ohta et al. [14] | 4 months | 300 mg weekly for 2 doses then, every 3 weeks | Cefdinir ongoing | Meningococcal ACYW-135 polysaccharide after eculizumab | At 22 month old, serum creatinine 0.33 mg/dL, no proteinuria |
| Gilbert et al . [7] | 4 months | 300 mg weekly for 2 doses then, every 3 weeks | NR | NR | NR |
| Besbas et al. [2] | 6 months | 300 mg weekly for 3 weeks then, 600 mg every 2 weeks | NR | NR | At 20 months old, normal renal function |
| Kim et al. [15] | 7 months | 300 mg weekly for 2 doses then, every 3 weeks | NR | Meningococcal ACYW-135 2 weeks before eculizumab |
At 18 months old, creatinine eGFR 42 mL/min/1.73m2 |
| Giordano et al. [16] | 1 year | 300 mg weekly for 4 weeks then, every 2 weeks for 2 months then, every 3 weeks | NR | Meningococcal vaccine* before eculizumab | At 23 months old, creatinine 0.51 mg/dL, proteinuria (urine protein/creatinine ratio 0.47) |
NR = not reported; eGFR = estimated glomerular filtration rate. *Meningococcal serotypes not reported.