Eculizumab for Severe Thrombotic Microangiopathy Secondary to Surgical Invasive Stress and Bleeding

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  • Fujita Yoko
    Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
  • Terashita Maho
    Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
  • Yazawa Masahiko
    Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
  • Yamasaki Yukitaka
    Department of Infectious Disease, St. Marianna University School of Medicine, Japan
  • Imamura Tomonori
    Department of Emergency and Critical Care Medicine, Tokyo Metropolitan Police Hospital, Japan
  • Kibayashi Junichiro
    Department of Obstetrics and Gynecology, Yokohama General Hospital, Japan
  • Sawai Toshihiro
    Department of Pediatrics, Shiga University of Medical Science, Japan
  • Hidaka Yoshihiko
    Department of Molecular Genetics, Wakayama Medical University, Japan The Japanese Association for Complement Research, Japan
  • Ohtani Katsuki
    The Japanese Association for Complement Research, Japan Department of Food and Health Sciences, Rakuno Gakuen University, Japan
  • Inoue Norimitsu
    Department of Molecular Genetics, Wakayama Medical University, Japan The Japanese Association for Complement Research, Japan
  • Shibagaki Yugo
    Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan

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説明

<p>Atypical hemolytic uremic syndrome (aHUS) is an extremely rare condition caused by an excessive activation of the complement pathway based on genetic or acquired dysfunctions in complement regulation, leading to thrombotic microangiopathy (TMA). A complement-amplifying condition (CAC) can trigger aHUS occurrence along with complement abnormality. We herein report a case of severe TMA after laparoscopic myomectomy in a healthy woman. This case was eventually diagnosed as complement-mediated TMA secondary to surgical invasive stress as a CAC, with no definitive diagnosis of aHUS despite a genetic test. The patient fully recovered after several eculizumab administrations. </p>

収録刊行物

  • Internal Medicine

    Internal Medicine 59 (1), 93-99, 2020-01-01

    一般社団法人 日本内科学会

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