Eculizumab treatment of thrombotic microangiopathy in a patient with ulcerative colitis.
Clin J Gastroenterol 2019;
13:344-348. [PMID:
31612381 DOI:
10.1007/s12328-019-01052-z]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
Secondary thrombotic microangiopathy (TMA) can be induced by several underlying conditions and drugs, yet coexistence of TMA and inflammatory bowel disease (IBD) has only infrequently been documented. A successful management beyond supportive care in cases with secondary TMA represents a challenge, as some underlying conditions might amplify complement dysregulation or even unmask a genetic predisposition to atypical hemolytic uremic syndrome (HUS)-both of which could require treatment with a complement blocking agent. We observed a case in which TMA developed in a patient with ulcerative colitis (UC). Genetic screening showed a heterozygous mutation in diacylglycerol kinase ε (DGKE). Eculizumab resulted in complete resolution of TMA, however UC relapsed after cessation of eculizumab.
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