Table 2.
Triggers to aHUS.
| Novel Triggers to aHUS | ||||||
|---|---|---|---|---|---|---|
| COVID-19 | Hepatitis B Vaccine | |||||
| Mahajan et al. | Alizadeh et al. | Kaufeld et al. | Avci et al. | Geerdink et al. | ||
| Year | 2020 | 2021 | 2021 | 2013 | 2012 | |
| Sample Size | 1 | 1 | 1 | 1 | 1 | 1 |
| Age (Months) | 14 | 1.3 | 22 | 52 | 0.15 | - |
| Symptoms at Onset | Abdominal pain Diarrhea Vomiting Myalgias Chest pain |
Fever Tachycardia Tachypnea Metabolic Acidosis |
Diarrhea Vomiting Loss of taste Hypertension |
Loss of taste Fever Abdominal pain Hypertension |
Jaundice Pulse rate: 140/min Respiratory rate: 48/min BP: 70/40 mmHg |
x |
| Lab Results | ↑Ferritin >100,000 ng/mL, ↑CRP > 300 mg/dL, WBC 33,000/µL SCr 0.7 mg/dL ↓Platelets 126,000/mL ↓Hgb 6.8 g/dL ↑LDH 4087 U/L ↑Bilirubin 6.2 mg/dL Schistocytes ↓C3 33 mg/dL ↓C4 1.0 mg/dL |
↓Bicarbonate 4 mmol/L ↓PC02 17 mmHg ↓Anion gap 40 ↑Glucose 805 mg/dL ↑WBC 33,000 ↑Procalcitonin 3 ng/mL |
↑LDH 2066 U/L ↓Hgb 5.5 g/dL |
↑LDH 88,560 U/L ↓Hgb 9.4 g/dl |
↓Hgb 51 g/L Leukocyte count 10 × 109/L Platelet count 28 × 109/L ↑Reticulocyte level 3.9% ↑Urea 88 mg/dL SCr 1.1 mg/dL ↑Total bilirubin 13.7 mg/dL ↑Direct bilirubin 2.6 mg/dL Uric acid 8.1 mg/dL ↑Asp aminotransferase 96 U/L ↑LDH 4641 U/L |
x |
| Progressing Lab Results |
↑SCr 8.97 mg/dL ↑BUN 170 mg/dL |
↓Platelets <100 K/uL ↑Reticulosytosis 13% ↑LDH 3190 U/L ↑Bilirubmin 1.5 mg/dL ↑Fibrinogen 557 mg/dL ↑Ferritin 1493 ng/mL ↑BUN 39 mg/dL ↑Creatinine 0.39 mg/dL C3 142 mg/dL C4 19 mg/dL |
↑SCr 6.33 mg/dL ↓Platelets 28 k cells/uL |
↑SCr 2.88 mg/dL ↓Platelets 128 k/uL |
x | x |
Novel triggers to aHUS, presenting case studies with symptoms at onset, admission lab results, and developing lab results throughout the hospital stay. BP: blood pressure; CRP: complement reactive protein; SCr: serum creatinine; Hgb: hemoglobin; LDH: lactase dehydrogenase; C3: complement factor 3; C4: complement factor 4; BUN: blood urea nitrogen; PC02: partial pressure of carbon dioxide.