Eculizumab Utilization in Hemolytic Uremic Syndrome (HUS) Presenting with Acute Hemolysis

Abstract

Background: Hemolytic uremic syndrome (HUS) is thrombotic microangiopathy in which microthrombi are formed, consisting mainly of platelets, which will occlude the arterioles and capillaries leading to a triad of intravascular hemolysis, thrombocytopenia, and acute kidney failure. Case Presentation: A 2-year-old boy presented to our outpatient clinic with persistent diarrhea streaked with blood, vomiting, signs of dehydration, and an ingested throat. The complete blood count (CBC) revealed acute hemolysis with mild normocytic hypochromic anemia, anisopoikilocytosis, fragmented red blood cells, and moderate thrombocytopenia. The patient experienced a drastic course which was dramatically improved after the administration of eculizumab. Conclusion: Eculizumab is a recombinant humanized monoclonal antibody against complement component C5; that effectively blocks the cleavage of complement factor C5 and, subsequently, the complement membrane attacks complex C5B-9.78. While on eculizumab, our patient's kidney function improved significantly after the first dose with a creatinine of 0.56 mg/dl.