COVID-19 associated thrombotic microangiopathy

被引：6

作者：

Yilmaz, Esra Karabag ^{[1
]}

Cebi, Memnune Nur ^{[2
]}

Karahan, Iremnaz ^{[2
]}

Saygili, Seha ^{[1
]}

Gulmez, Ruveyda ^{[1
]}

Demirgan, Ebru Burcu ^{[3
]}

Durak, Cansu ^{[4
]}

Aygun, Fatih ^{[5
]}

Ozaltin, Fatih ^{[6
,7
]}

Caliskan, Salim ^{[1
]}

Canpolat, Nur ^{[1
]}

机构：

[1] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Paediat Nephrol, Istanbul, Turkiye

[2] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Paediat, Istanbul, Turkiye

[3] Istanbul Training & Res Hosp, Dept Paediat Nephrol, Istanbul, Turkiye

[4] Sancaktepe Sehit Prof Dr Ilhan Varank Training & R, Dept Paediat Intens Care Unit, Istanbul, Turkiye

[5] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Paediat Intens Care Unit, Istanbul, Turkiye

[6] Hacettepe Univ, Dept Pediat, Nephrogenet Lab, Sch Med, Ankara, Turkiye

[7] Hacettepe Univ, Fac Med, Dept Paediat Nephrol, Ankara, Turkiye

来源：

NEPHROLOGY | 2023年 / 28卷 / 10期

关键词：

COVID-19; eculizumab; HUS; thrombotic microangiopathy; TMA;

D O I：

10.1111/nep.14225

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

A limited number of cases of thrombotic microangiopathy (TMA) have previously been reported in association with COVID-19. Our report describes two cases of TMA associated with COVID-19, one of which was successfully treated with eculizumab. The first case was a 23-month-old girl, and the second case was a 9-month-old boy. PCR tests for SARS-CoV-2 were positive in both cases, and laboratory results showed microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. No known aetiology for TMA was found in either case. Stool tests for Shigatoxin-producing Escherichia coli were negative. Coagulation tests, ADAMTS13 activity, serum complement levels, and homocysteine levels were all within the normal range. No known genetic mutation was found, including mutations of complement, diacylglycerol kinase epsilon, and cobalamin C. In the first case, eculizumab was administered due to persistent haemolysis and prolonged anuria. In conclusion, TMA may be associated with COVID-19 infection. Treatment with eculizumab may be beneficial in selected patients because of the potential activation of the complement system.

引用

页码：557 / 560

页数：4

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