Reduced membrane attack complex formation in umbilical cord blood during Eculizumab treatment of the mother: A case report

Subagini Nagarajah, Martin Tepel*, Christian Nielsen, Kristian Assing, Yaseelan Palarasah, Lise Lotte Torvin Andersen, Lotte Borg Lange, Claus Bistrup

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Resumé

Background: Atypical hemolytic uremic syndrome (aHUS) is a disorder of the microvasculature with hemolytic anemia, thrombocytopenia and acute kidney injury. Nowadays, aHUS is successfully treated with eculizumab, a humanized, chimeric IgG2/4 kappa antibody, which binds human complement C5 and blocks generation of C5a and membrane-attack-complex. Case presentation: A 25-year-old woman with end stage renal disease due to relapsing atypical hemolytic uremic syndrome had a relapse of the disease during pregnancy. She was treated with eculizumab. We measured reduced formation of the membrane-attack complex in newborn's umbilical cord vein blood using the sensitive and specific Palarasah-Nielsen-ELISA. Conclusions: Eculizumab treatment of the mother with end stage renal disease may cause reduced innate immunity which could render newborns more susceptible to infections.

OriginalsprogEngelsk
Artikelnummer307
TidsskriftBMC Nephrology
Vol/bind20
Antal sider5
ISSN1471-2369
DOI
StatusUdgivet - 7. aug. 2019

Fingeraftryk

Complement Membrane Attack Complex
Fetal Blood
Mothers
Newborn Infant
Umbilical Veins
eculizumab

Citer dette

@article{30056e8cd89a411dafe890d1cd5abd16,
title = "Reduced membrane attack complex formation in umbilical cord blood during Eculizumab treatment of the mother: A case report",
abstract = "Background: Atypical hemolytic uremic syndrome (aHUS) is a disorder of the microvasculature with hemolytic anemia, thrombocytopenia and acute kidney injury. Nowadays, aHUS is successfully treated with eculizumab, a humanized, chimeric IgG2/4 kappa antibody, which binds human complement C5 and blocks generation of C5a and membrane-attack-complex. Case presentation: A 25-year-old woman with end stage renal disease due to relapsing atypical hemolytic uremic syndrome had a relapse of the disease during pregnancy. She was treated with eculizumab. We measured reduced formation of the membrane-attack complex in newborn's umbilical cord vein blood using the sensitive and specific Palarasah-Nielsen-ELISA. Conclusions: Eculizumab treatment of the mother with end stage renal disease may cause reduced innate immunity which could render newborns more susceptible to infections.",
keywords = "Atypical hemolytic uremic syndrome, Complement, Eculizumab, End-stage renal disease, Membrane-attack complex, Pregnancy, Umbilical cord vein blood",
author = "Subagini Nagarajah and Martin Tepel and Christian Nielsen and Kristian Assing and Yaseelan Palarasah and Andersen, {Lise Lotte Torvin} and Lange, {Lotte Borg} and Claus Bistrup",
year = "2019",
month = "8",
day = "7",
doi = "10.1186/s12882-019-1469-9",
language = "English",
volume = "20",
journal = "B M C Nephrology",
issn = "1471-2369",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Reduced membrane attack complex formation in umbilical cord blood during Eculizumab treatment of the mother

T2 - A case report

AU - Nagarajah, Subagini

AU - Tepel, Martin

AU - Nielsen, Christian

AU - Assing, Kristian

AU - Palarasah, Yaseelan

AU - Andersen, Lise Lotte Torvin

AU - Lange, Lotte Borg

AU - Bistrup, Claus

PY - 2019/8/7

Y1 - 2019/8/7

N2 - Background: Atypical hemolytic uremic syndrome (aHUS) is a disorder of the microvasculature with hemolytic anemia, thrombocytopenia and acute kidney injury. Nowadays, aHUS is successfully treated with eculizumab, a humanized, chimeric IgG2/4 kappa antibody, which binds human complement C5 and blocks generation of C5a and membrane-attack-complex. Case presentation: A 25-year-old woman with end stage renal disease due to relapsing atypical hemolytic uremic syndrome had a relapse of the disease during pregnancy. She was treated with eculizumab. We measured reduced formation of the membrane-attack complex in newborn's umbilical cord vein blood using the sensitive and specific Palarasah-Nielsen-ELISA. Conclusions: Eculizumab treatment of the mother with end stage renal disease may cause reduced innate immunity which could render newborns more susceptible to infections.

AB - Background: Atypical hemolytic uremic syndrome (aHUS) is a disorder of the microvasculature with hemolytic anemia, thrombocytopenia and acute kidney injury. Nowadays, aHUS is successfully treated with eculizumab, a humanized, chimeric IgG2/4 kappa antibody, which binds human complement C5 and blocks generation of C5a and membrane-attack-complex. Case presentation: A 25-year-old woman with end stage renal disease due to relapsing atypical hemolytic uremic syndrome had a relapse of the disease during pregnancy. She was treated with eculizumab. We measured reduced formation of the membrane-attack complex in newborn's umbilical cord vein blood using the sensitive and specific Palarasah-Nielsen-ELISA. Conclusions: Eculizumab treatment of the mother with end stage renal disease may cause reduced innate immunity which could render newborns more susceptible to infections.

KW - Atypical hemolytic uremic syndrome

KW - Complement

KW - Eculizumab

KW - End-stage renal disease

KW - Membrane-attack complex

KW - Pregnancy

KW - Umbilical cord vein blood

U2 - 10.1186/s12882-019-1469-9

DO - 10.1186/s12882-019-1469-9

M3 - Journal article

C2 - 31390992

AN - SCOPUS:85071949106

VL - 20

JO - B M C Nephrology

JF - B M C Nephrology

SN - 1471-2369

M1 - 307

ER -