Atypical hemolytic uremic syndrome: a case study

Atypical hemolytic uremic syndrome (aHUS) is a systemic disease, a type of thrombotic microangiopathy (TMA). It is based on uncontrolled activation of the alternative complement pathway of a hereditary or acquired nature, leading to generalized thrombosis in the microvasculature. Chronic activation of the alternative complement pathway leads to the damage of endothelial cells, erythrocytes and platelets and, as a result, to thrombotic microangiopathy and systemic multiorgan damage. Currently, in roughly half of the cases, it is impossible to identify aHUS triggers. Fresh frozen plasma (FFP) is used as first-line drug to reverse the symptoms. It helps to eliminate the deficiency of self-proteins complement factor H and complement factor I (CFH and CFI), membrane cofactor protein (MCP), and stable and labile proteins factors of hemostasis, and to stop thrombosis in the microvasculature. FFP administration is a preparatory step before anticomplementary therapy. Disease prognosis is always serious and is associated with severe complications and high mortality. At least 6 % of patients develop multiple organ failure with generalized TMA, injury of the central nervous system, gastrointestinal tract, lungs, and kidneys. The paper describes a clinical case of a patient with aHUS.