Atypical hemolytic uremic syndrome (aHUS) is a life-threatening disease that leads to end-stage\nkidney disease if only a poor response to plasma exchanges (PEs) or eculizumab therapy is achieved.\nCase presentation: A 58-year-old Japanese man presented with thrombocytopenia, anemia, and kidney failure\nrequiring dialysis without any underlying disease. A kidney biopsy revealed marked mesangiolysis in all glomeruli,\ncompatible with thrombotic microangiopathy (TMA). Based on the positive anti- factor H antibody and negative\nresult for secondary TMA, we diagnosed him as aHUS. Despite eculizumab administration after eight sessions of PE,\nneither platelet normalization nor kidney recovery was achieved. Eight months later, we discontinued eculizumab\ntherapy due to anaphylactic reaction. At 15 months after the onset of TMA, his platelet count increased gradually\nfrom 40....................
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