Infant onset severe complement‐mediated hemolytic uremic syndrome complicated by secondary sclerosing cholangitis

Yeşilbaş, Osman; Şevketoğlu, Esra; Petmezci, Mey Talip; Kıhtır, Hasan Serdar; Benzer, Meryem; Arıkan, Çiğdem; Berdeli, Afig; Baloğlu, Hüseyi̇n; Başkan, Özdil

doi:10.1002/jca.21651

Cited by 1 publication

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“…Hepatotoxicity in association with eculizumab has been reported in the literature. [12][13][14] Hayes et al reported elevated aminotransferases in 7 of 11 children treated with eculizumab. 12 One patient was discontinued because of excessive elevation of liver enzymes, jaundice, and clinical symptoms of tender hepatomegaly after eculizumab infusion.…”

Section: Discussionmentioning

confidence: 99%

Acute Myocarditis and Eculizumab Caused Severe Cholestasis in a 17-Month-Old Child Who Has Hemolytic Uremic Syndrome Associated with Shiga Toxin-Producing Escherichia coli

Yeşilbaş

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Sonmez

et al. 2020

J Pediatr Intensive Care

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Cardiovascular involvement is uncommon in pediatric patients with hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC-HUS). We presented a case of 17-month-old toddler who had a sporadic type of STEC-HUS complicated by acute myocarditis. The patient was successfully treated by a single dose of eculizumab after six doses of therapeutic plasma exchange (TPE) were inefficient to prevent the cardiac complication. Hepatotoxicity was observed after a single dose of eculizumab. Hepatic and cholestatic enzyme levels slowly returned to normal within 6 months. To the best of our knowledge, this is the first case of myocarditis/cardiomyopathy treated with eculizumab in STEC-HUS. This case illustrates the need for vigilance regarding myocardial involvement and eculizumab-induced hepatotoxicity in STEC-HUS.

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