Age at presentation and clinical course. All but 1 individual presented in the first 2 years of life, and most individuals experienced thrombotic microangiopathy relapses in early childhood. Two individuals have developed end-stage renal disease (ESRD) >20 years after the initial presentation, and 1 has received a kidney transplant. Six individuals have been treated with eculizumab, 1 with relapses on treatment, and in 4, it has been withdrawn. NCL28 is not included in the figure because of insufficient data being available. The scale is increased for the first 5 years of life to depict the detail of the relapses. aHUS, atypical hemolytic uremic syndrome.