Atypical Hemolytic Uremic Syndrome: A Nationwide Colombian Pediatric Series

datacite.rightshttp://purl.org/coar/access_right/c_abf2eng
dc.contributor.authorEspitaleta, Zilac
dc.contributor.authorDomínguez-Vargas, Alex
dc.contributor.authorVillamizar-Martínez, Johanna
dc.contributor.authorCarrascal-Guzmán, Martha
dc.contributor.authorGuerrero-Tinoco, Gustavo
dc.contributor.authorPinto-Bernal, Claudia
dc.contributor.authorGonzález-Chaparro, Luz
dc.contributor.authorRojas-Rosas, Luisa
dc.contributor.authorAmado-Niño, Pilar
dc.contributor.authorCastillo-Arteaga, Mariángel
dc.contributor.authorAlvarez-Gómez, Yeferson
dc.contributor.authorArguello-Muñoz, Laura
dc.contributor.authorMorales-Camacho, William
dc.contributor.authorLeón-Guerra, Oscar
dc.contributor.authorEgea, Eduardo
dc.contributor.authorGaleano-Rodríguez, Ricardo
dc.contributor.authorQuintero-Gómez, Ana
dc.contributor.authorAroca-Martínez, Gustavo
dc.contributor.authorMusso, Carlos G.
dc.date.accessioned2024-02-14T16:18:05Z
dc.date.available2024-02-14T16:18:05Z
dc.date.issued2024
dc.description.abstractObjectives. Atypical hemolytic uremic syndrome (aHUS) is a rare complement-mediated kidney disease with genetic predisposition and represents up to 10% of pediatric hemolytic uremic syndrome (HUS) cases. Few studies have evaluated aHUS in Latin American population. We studied a Colombian pediatric cohort to delineate disease presentation and outcomes. Methods. A multicenter cohort of 27 Colombian children with aHUS were included. Patients were grouped by age at onset. Clinical features were compared using analysis of variance (ANOVA) and Fisher exact tests. Renal biopsy was performed on 6 patients who were suspected of having other renal diseases before aHUS diagnosis. Results. Most patients were male (70%). The onset of aHUS occurred frequently before age 4 years (60%) and followed gastroenteritis as the main triggering event (52%). Age groups showed comparable clinical presentation, disease severity, treatment, and outcomes. Pulmonary involvement (67%) was the main extrarenal manifestation, particularly in the 1 to 7 age group (P = .01). Renal biopsies were as follows: 3 had membranoproliferative glomerulonephritis (MPGN) type I, one MPGN type III, one C3-glomerulonephritis, and one rapidly progressive GN. Genetic screening was available in 6 patients and identified 2xCFHR5, 2xMCP, 1xADAMTS13/ THBD, and 1xDGKE mutations. A total of 15 relapses were seen, of which 8 (72%) occurred in the 1 to 7 age group. The renal outcome was not significantly different regardless of age group. Conclusion. In our cohort, we observed a relatively high frequency of extrarenal involvement at first presentation represented by pulmonary manifestations. The renal prognosis at initial presentation was worse than in previous reports.spa
dc.format.mimetypepdfspa
dc.identifier.doihttps://doi.org/10.1177/2333794X241231133
dc.identifier.issn2333794X (Electrónico)
dc.identifier.urihttps://hdl.handle.net/20.500.12442/14129
dc.identifier.urlhttps://journals.sagepub.com/doi/10.1177/2333794X241231133
dc.language.isoengeng
dc.publisherSageeng
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacionaleng
dc.rights.accessrightsinfo:eu-repo/semantics/openAccesseng
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceGlobal Pediatric Healtheng
dc.sourceVol. 11 Año (2024)
dc.subjectPediatric atypical hemolytic uremic syndromeeng
dc.subjectThrombotic microangiopathyeng
dc.subjectExtrarenal manifestationseng
dc.titleAtypical Hemolytic Uremic Syndrome: A Nationwide Colombian Pediatric Seriesspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.spaArtículo científicospa
dcterms.referencesZipfel PF, Heinen S, Skerka C. Thrombotic microangiopathies: new insights and new challenges. Curr Opin Nephrol Hypertens. 2010;19(4):372-378. doi:10.1097/ MNH.0b013e32833aff4aeng
dcterms.referencesNoris M, Remuzzi G. Atypical hemolytic-uremic syndrome. New Engl J Med. 2009;361(17):1676-1687. doi:10.1056/NEJMra0902814eng
dcterms.referencesKurosawa S, Stearns-Kurosawa DJ. Complement, thrombotic microangiopathy and disseminated intravascular coagulation. J Intensive Care. 2014;2(1):65. doi:10.1186/ s40560-014-0061-4eng
dcterms.referencesYan K, Desai K, Gullapalli L, Druyts E, Balijepalli C. Epidemiology of atypical hemolytic uremic syndrome: a systematic literature review. Clin Epidemiol. 2020;12:295-305. doi:10.2147/CLEP.S245642eng
dcterms.referencesNoris M, Caprioli J, Bresin E, et al. Relative role of genetic complement abnormalities in sporadic and familial aHUS and their impact on clinical phenotype. Clin J Am Soc Nephrol. 2010;5(10):1844-1859. doi:10.2215/ CJN.02210310eng
dcterms.referencesDragon-Durey MA, Loirat C, Cloarec S, et al. Anti-factor H autoantibodies associated with atypical hemolytic uremic syndrome. J Am Soc Nephrol. 2005;16(2):555-563. doi:10.1681/ASN.2004050380eng
dcterms.referencesBu F, Maga T, Meyer NC, et al. Comprehensive genetic analysis of complement and coagulation genes in atypical hemolytic uremic syndrome. J Am Soc Nephrol. 2014;25(1):55-64. doi:10.1681/ASN.2013050453eng
dcterms.referencesCaprioli J, Noris M, Brioschi S, et al. Genetics of HUS: the impact of MCP, CFH, and IF mutations on clinical presentation, response to treatment, and outcome. Blood. 2006;108(4):1267-1279. doi:10.1182/blood-2005-10-007 252eng
dcterms.referencesRaina R, Krishnappa V, Blaha T, et al. Atypical hemolytic- uremic syndrome: an update on pathophysiology, diagnosis, and treatment. Ther Apher Dial. 2019;23(1):4- 21. doi:10.1111/1744-9987.12763eng
dcterms.referencesCaprioli J, Bettinaglio P, Zipfel PF, et al. The molecular basis of familial hemolytic uremic syndrome: mutation analysis of factor H gene reveals a hot spot in short consensus repeat 20. J Am Soc Nephrol. 2001;12(2):297-307. doi:10.1681/ASN.V122297eng
dcterms.referencesFremeaux-Bacchi V, Fakhouri F, Garnier A, et al. Genetics and outcome of atypical hemolytic uremic syndrome: a nationwide french series comparing children and adults. Clin J Am Soc Nephrol. 2013;8(4):554-562. doi:10.2215/ CJN.04760512eng
dcterms.referencesKavanagh D, Richards A, Noris M, et al. Characterization of mutations in complement factor I (CFI) associated with hemolytic uremic syndrome. Mol Immunol. 2008;45(1):95-105. doi:10.1016/j.molimm.2007.05.004eng
dcterms.referencesGoicoechea de, Jorge E, Harris CL, Esparza-Gordillo J, et al. Gain-of-function mutations in complement factor B are associated with atypical hemolytic uremic syndrome. Proc Natl Acad Sci USA. 2007;104(1):240-245. doi:10.1073/pnas.0603420103eng
dcterms.referencesFrémeaux-Bacchi V, Miller EC, Liszewski MK, et al. Mutations in complement C3 predispose to development of atypical hemolytic uremic syndrome. Blood. 2008; 112(13):4948-4952. doi:10.1182/blood-2008-01-133702eng
dcterms.referencesDelvaeye M, Noris M, De Vriese A, et al. Thrombomodulin mutations in atypical hemolytic-uremic syndrome. New Engl J Med. 2009;361(4):345-357. doi:10.1056/NEJMoa 0810739eng
dcterms.referencesMunoz J. Therapeutic apheresis procedures: mechanisms of action and immunomodulatory effects. ISBT Sci Ser. 2008;3(1):95-103. doi:10.1111/j.1751-2824.20 08.00178.xeng
dcterms.referencesMills MC, Rahal C. A scientometric review of genomewide association studies. Commun Biol. 2019;2(1):9. doi:10.1038/s42003-018-0261-xeng
dcterms.referencesJiménez-Kaufmann A, Chong AY, Cortés A, et al. Imputation performance in Latin American populations: improving rare variants representation with the inclusion of Native American genomes. Front Genet. 2021;12:719791- 719811. doi:10.3389/fgene.2021.719791eng
dcterms.referencesHomburger JR, Moreno-Estrada A, Gignoux CR, et al. Genomic insights into the ancestry and demographic history of South America. PLoS Genet. 2015;11(12):e10056 02-e1005626. doi:10.1371/journal.pgen.1005602eng
dcterms.referencesConley AB, Rishishwar L, Norris ET, et al. A comparative analysis of genetic ancestry and admixture in the Colombian populations of chocó and Medellín. G3 Genes Genome Genet. 2017;7(10):3435-3447. doi:10.1534/g3.117.1118eng
dcterms.referencesGeerdink LM, Westra D, van Wijk JA, et al. Atypical hemolytic uremic syndrome in children: complement mutations and clinical characteristics. Pediatr Nephrol. 2012;27(8):1283-1291. doi:10.1007/s00467-012-2131-yeng
dcterms.referencesCórdoba JP, Contreras KM, Larrarte C, et al. Síndrome hemolítico urémico atípico, revisión de la literatura y documento de consenso. Enfoque diagnóstico y tratamiento. Rev Colomb Nefrol. 2015;2(1):19-40.eng
dcterms.referencesRondeau E, Cataland SR, Al-Dakkak I, et al. Eculizumab safety: five-year experience from the global atypical hemolytic uremic syndrome registry. Kidney Int Rep. 2019;4(11):1568-1576. doi:10.1016/j.ekir.2019.07.016eng
dcterms.referencesBrodsky RA. Eculizumab and aHUS: to stop or not. Blood. 2021;137(18):2419-2420. doi:10.1182/blood.202 0010234eng
dcterms.referencesR Core Team. R: A Language and Environment for Statistical Computing. Published online 2015.eng
dcterms.referencesZhao J, Wu H, Khosravi M, et al. Association of genetic variants in complement factor H and factor H-related genes with systemic lupus erythematosus susceptibility. PLoS Genet. 2011;7(5):e1002079. doi:10.1371/journal.pgen.1002079eng
dcterms.referencesManenti L, Gnappi E, Vaglio A, et al. Atypical haemolytic uraemic syndrome with underlying glomerulopathies. A case series and a review of the literature. Nephrol Dial Transplant. 2013;28(9):2246-2259. doi:10.1093/ndt/ gft220eng
dcterms.referencesFormeck C, Swiatecka-Urban A. Extra-renal manifestations of atypical hemolytic uremic syndrome. Pediatr Nephrol. 2019;34(8):1337-1348. doi:10.1007/s00467-018- 4039-7eng
dcterms.referencesSchaefer F, Ardissino G, Ariceta G, et al. Clinical and genetic predictors of atypical hemolytic uremic syndrome phenotype and outcome. Kidney Int. 2018;94(2):408-418. doi:10.1016/j.kint.2018.02.029eng
dcterms.referencesHofer J, Rosales A, Fischer C, Giner T. Extra-renal manifestations of complement-mediated thrombotic microangiopathies. Front Pediatr. 2014;2:97. doi:10.3389/fped.2014 .00097eng
dcterms.referencesCabarcas-Barbosa O, Aroca-Martínez G, Musso CG, et al. Atypical hemolytic uremic syndrome in the Colombian Caribbean: its particular characteristics. Int Urol Nephrol. 2022;54(6):1323-1330. doi:10.1007/s11255-021-03011-5eng
dcterms.referencesBrackman D, Sartz L, Leh S, et al. Thrombotic microangiopathy mimicking membranoproliferative glomerulonephritis. Nephrol Dial Transplant. 2011;26(10):3399-3403. doi:10.1093/ndt/gfr422eng
dcterms.referencesSiegler RL, Brewer ED, Pysher TJ. Hemolytic uremic syndrome associated with glomerular disease. Am J Kidney Dis. 1989;13(2):144-147. doi:10.1016/s0272-6386(89)80133-7eng
dcterms.referencesDische FE, Culliford EJ, Parsons V. Haemolytic uraemic syndrome and idiopathic membranous glomerulonephritis. Br Med J. 1978;1(6120):1112-1113. doi:10.1136/ bmj.1.6120.1112eng
dcterms.referencesJha V, Murthy MS, Kohli HS, et al. Secondary membranoproliferative glomerulonephritis due to hemolytic uremic syndrome: an unusual presentation. Ren Fail. 1998;20(6):845-850. doi:10.3109/08860229809045182eng
dcterms.referencesLicht C, Fremeaux-Bacchi V. Hereditary and acquired complement dysregulation in membranoproliferative glomerulonephritis. Thromb Haemost. 2009;101(2):271- 278. doi:10.1160/TH08-09-0575eng
dcterms.referencesBarbour TD, Ruseva MM, Pickering MC. Update on C3 glomerulopathy. Nephrol Dial Transplant. 2016;31(5):717-725. doi:10.1093/ndt/gfu317eng
dcterms.referencesNoris M, Donadelli R, Remuzzi G. Autoimmune abnormalities of the alternative complement pathway in membranoproliferative glomerulonephritis and C3 glomerulopathy. Pediatr Nephrol. 2019;34:1311-1323. doi:10.1007/s00467- 018-3989-0eng
dcterms.referencesJózsi M, Barlow PN, Meri S. Editorial: function and dysfunction of complement factor H. Front Immunol. 2021;12:831044. doi:10.3389/fimmu.2021.831044eng
dcterms.referencesZhang Y, Ghiringhelli Borsa N, Shao D, et al. Factor H autoantibodies and complement-mediated diseases. Front Immunol. 2020;11:607211. doi:10.3389/fimmu.2020.60 7211eng
dcterms.referencesGatault P, Brachet G, Ternant D, et al. Therapeutic drug monitoring of eculizumab: Rationale for an individualized dosing schedule. mAbs. 2015;7(6):1205-1211. doi:10.108 0/19420862.2015.1086049eng
dcterms.referencesGreenbaum LA, Fila M, Ardissino G, et al. Eculizumab is a safe and effective treatment in pediatric patients with atypical hemolytic uremic syndrome. Kidney Int. 2016;89(3):701-711. doi:10.1016/j.kint.2015.11.026eng
oaire.versioninfo:eu-repo/semantics/acceptedVersionspa

Archivos

Bloque original
Mostrando 1 - 1 de 1
Cargando...
Miniatura
Nombre:
PDF.pdf
Tamaño:
826.34 KB
Formato:
Adobe Portable Document Format
Descripción:
PDF
Bloque de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
381 B
Formato:
Item-specific license agreed upon to submission
Descripción:

Colecciones