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01-02-2018 | Case Report

A case of atypical hemolytic uremic syndrome in a second renal transplant

Authors: Nicholas A. Zwang, Bing Ho, Yashpal S. Kanwar, Brad Lewis, Matthew Cusick, John J. Friedewald, Lorenzo Gallon

Published in: Journal of Nephrology | Issue 1/2018

Abstract

Atypical hemolytic uremic syndrome (aHUS) has gained increased visibility over several years as an important cause of renal failure. Unfortunately, diagnosis is often difficult because individual courses can be highly variable depending the causative genetic mutations. Here we present the case of a patient with a failed renal allograft and acute failure of a second allograft who was ultimately diagnosed with aHUS. Interestingly, he developed early de novo donor specific antibodies (DSA) after the second renal transplant in context of likely recurrent aHUS. Terminal complement inhibition with eculizumab resulted in prompt improvement of renal allograft function.

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Recipient HLA typing was as follows: A11, A24, B18, B35, DR4, DR53 (there was no C, DQ or DP tying for the recipient). Donor HLA typing was as follows: A2, A68, B53, C4, DR13, DR16, DQ2, and DQ5 (there was no donor DP typing).

Recipient HLA typing was as follows: A11, A24, B18, B35, DR4, DR53 (there was no C, DQ or DP tying for the recipient). Donor HLA typing was as follows: A1, A24, B7, B62, C7, C10, DR4, DR53, DQ8, DP3, and DP14. There was no history of Class II donor specific antibodies pre- or post-transplant.

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Title: A case of atypical hemolytic uremic syndrome in a second renal transplant
Authors: Nicholas A. Zwang
Bing Ho
Yashpal S. Kanwar
Brad Lewis
Matthew Cusick
John J. Friedewald
Lorenzo Gallon
Publication date: 01-02-2018
Publisher: Springer International Publishing
Published in: Journal of Nephrology / Issue 1/2018
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-016-0373-7

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