Polish Journal of Paediatrics
en POLSKI
eISSN: 2300-8660
ISSN: 0031-3939
Pediatria Polska - Polish Journal of Paediatrics
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abstract:
Case report

A rare complication of eculizumab treatment for atypical hemolytic uremic syndrome

Agnieszka Maria Cyran
1, 2
,
Iwona Ogarek
1, 2
,
Joanna Kwinta-Rybicka
1, 2
,
Dorota Drożdż
1, 2

  1. Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Nephrology and Hypertension, University Children’s Hospital, Kraków, Poland
Pediatr Pol 2025; 100 (4)
Online publish date: 2025/11/24
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Atypical hemolytic uremic syndrome (aHUS) is a rare, life-threatening disease characterized by uncontrolled activation of the complement system. The introduction of eculizumab, a monoclonal antibody that blocks the complement protein C5, has significantly improved patient prognosis. However, eculizumab treatment is associated with a risk of adverse effects. We report a severe and complex case of aHUS in a 4-year-old boy, triggered by viral infections (influenza A and parvovirus B19) and influenced by genetic predisposition. An unexpected complication – a severe rash following eculizumab administration – necessitated discontinuation of the drug. Given the patient’s genetic risk factors, crovalimab was planned as an alternative treatment in case of recurrence. At the one-year follow-up, the patient’s kidney function remained stable, indicating a favorable outcome. This case underscores the complexity of aHUS management, the importance of genetic screening, and the need for vigilance in monitoring adverse drug reactions.
keywords:

atypical hemolytic uremic syndrome, anti-C5 monoclonal antibody, eculizumab, thrombotic microangiopathies

 
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