Atypical hemolytic-uremic syndrome: Difference between revisions

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==Background==
==Background==

* One of the [[thrombotic microangiopathy|thrombotic microangiopathies]]
* See also [[hemolytic-uremic syndrome|typical hemolytic-uremic syndrome]], which occurs after infectious diarrhea


===Pathophysiology===
===Pathophysiology===


*Congenital defect leading to dysregulation of the alternative complement pathway, which leads to increased complement activity
* Congenital defect leading to dysregulation of the alternative complement pathway, which leads to increased complement activity


==Diagnosis==
==Diagnosis==

Revision as of 11:33, 15 August 2020

Background

Pathophysiology

  • Congenital defect leading to dysregulation of the alternative complement pathway, which leads to increased complement activity

Diagnosis

  • Genetic mutation analysis of complement regulatory proteins (CFH, CFI, MCP, C3, CFB, THBD) and anti-CFH antibodies

Management

  • Often unable to distinguish from TTP, so plasma exchange should be initiated promptly
  • If no improvement on PLEX and there is significant renal involvement, consider an aHUS-specific treatment
    • Eculizumab to inhibit complement, ideally with full meningococcal vaccination beforehand