Acute Myocarditis and Eculizumab Caused Severe Cholestasis in a 17-Month-Old Child Who Has Hemolytic Uremic Syndrome Associated with Shiga Toxin-Producing Escherichia coli

Abstract Cardiovascular involvement is uncommon in pediatric patients with hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC-HUS). In this case report we presented a case of 17-month-old toddler who had a sporadic type of STEC-HUS complicated by acute myocarditis...

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Bibliographic Details
Published in:	Journal of pediatric intensive care Vol. 10; no. 3; pp. 216 - 220
Main Authors:	Yesilbas, Osman, Yozgat, Can Yilmaz, Akinci, Nurver, Sonmez, Sirin, Tekin, Eser, Talebazadeh, Faraz, Jafarov, Uzeyir, Temur, Hafize Otcu, Yozgat, Yilmaz
Format:	Journal Article
Language:	English
Published:	Rüdigerstraße 14, 70469 Stuttgart, Germany Georg Thieme Verlag KG 01-09-2021
Subjects:	Case Report therapeutic plasma exchange eculizumab myocarditis hemolytic uremic syndrome
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Summary:	Abstract Cardiovascular involvement is uncommon in pediatric patients with hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC-HUS). In this case report we presented a case of 17-month-old toddler who had a sporadic type of STEC-HUS complicated by acute myocarditis. The patient was successfully treated by a single dose of eculizumab after six doses of therapeutic plasma exchange (TPE) were inefficient to prevent the cardiac complication. Hepatotoxicity was observed after a single dose of eculizumab. Hepatic and cholestatic enzyme levels slowly returned to normal within 6 months. To the best of our knowledge, this is the first case of myocarditis/cardiomyopathy treated with eculizumab in STEC-HUS. This case illustrates the need for vigilance regarding myocardial involvement and eculizumab-induced hepatotoxicity in STEC-HUS.
ISSN:	2146-4618 2146-4626
DOI:	10.1055/s-0040-1713111