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Cao M, Ferreiro T, Leite BN, Pita F, Bolaños L, Valdés F, Alonso A, Vázquez E, Mosquera J, Trigás M, Rodríguez S. Two cases of atypical hemolytic uremic syndrome (aHUS) and eosinophilic granulomatosis with polyangiitis (EGPA): a possible relationship. CEN Case Rep 2017; 6:91-97. [PMID: 28509134 DOI: 10.1007/s13730-017-0251-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/04/2017] [Indexed: 10/20/2022] Open
Abstract
Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by hemolysis, thrombocytopenia, and renal failure. It is related to genetic mutations of the alternative complement pathway and is difficult to differentiate from other prothrombotic microangiopathies. Eosinophilic granulomatosis with polyangiitis (EGPA) (Churg-Strauss syndrome, CSS) is a systemic ANCA-associated vasculitis and a hypereosinophilic disorder where eosinophils seem to induce cell apoptosis and necrosis and therefore, vasculitis. Here, we report the case of two CSS patients with a genetic complement disorder consistent with aHUS diagnosis. Both patients showed histologic features that supported the diagnosis of CSS, and a genetic complement study confirmed the suspected aHUS diagnosis. In the case where eculizumab was administered, the global response was excellent. There is very limited understanding of the genetics and epidemiology of both, atypical HUS and EGPA, but considering our two patients we suggest that an etiopathogenic link exists among patients diagnosed with both entities.
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Affiliation(s)
- Mercedes Cao
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain.
| | - Tamara Ferreiro
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Bruna N Leite
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Francisco Pita
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Luis Bolaños
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Francisco Valdés
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Angel Alonso
- Servicio de Nefrología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Eduardo Vázquez
- Servicio de Anatomía Patológica, Hospital Universitario A Coruña, A Coruña, Spain
| | - Juan Mosquera
- Servicio de Anatomía Patológica, Hospital Universitario A Coruña, A Coruña, Spain
| | - María Trigás
- Servicio de Medicina Interna, Hospital Arquitecto Marcide, El Ferrol, A Coruña, Spain
| | - Santiago Rodríguez
- Departamento de Medicina Celular y Molecular, Centro de Investigaciones Biológicas (CSIC), Madrid, Spain
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