Table 2.
Characteristics of TMA as a relapse of aHUS triggered by COVID-19
| Case | Sex, Age (years) | S-Cr (mg/dL) |
Platelet (× 104/μL) | LDH (U/L) or (× ULN) | COVID-19 treatment | TMA treatment | Complement genetics | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1 [1] | F, 52 | 2.9 | 31.8 | 885 | ND | HD eculizumab | CFH Cys931Tyr | ND |
| 2 [1] | F, 22 | 6.3 | 2.8 | 2,066 | ND | PE, HD eculizumab | CFH splice variant | ND |
| 3 [2] | M, 39 | 4.7 | 8 | 533 | ND | PE, HDF mPSL eculizumab | C3 Arg161Trp | ND |
| 4 [3] | F, 28 | 2.6 | 10.6 | > × 1.5 ULN | ND | ND | MCP Arg59stop | S-Cr 2.0 |
| 5 [4] | M, 66 | 10 | 5 | > ULN | – | – | CFH Ser756Thr | HD |
| 6 [4] | M, 71 | 2.3 | 1.6 | > × 1.7 ULN | Oxygen | PE eculizumab | C3 Lys155Gln | S-Cr 1.7 |
| 7 [4] | M, 35 | 7.9 | 1.1 | > × 9 ULN | – | PE eculizumab | CFI Ile416Leu | HD |
| 8 [4] | F, 26 | 7.2 | 2.2 | > ULN | – | PE eculizumab tacrolimus rituximab | CFH homozygous tgtgt haplotype | S-Cr 4.2 |
aHUS, atypical hemolytic uremic syndrome; CFH, complement factor H; CFI, complement factor I; HD, hemodialysis; HDF, hemodiafiltration; LDH, Lactate dehydrogenase; MCP, membrane cofactor protein; mPSL, methylprednisolone; ND, not described; PE, plasma exchange; S-CR, serum creatinine; TMA, thrombotic microangiopathy; ULN, upper limit normal