Efficacy of cascade plasmapheresis in comparison with conventional therapeutic plasma exchange for relapsed atypical hemolytic uremic syndrome: A case report

• Published in: Asian journal of transfusion science Vol. 16; no. 2; pp. 283 - 286
• Main Authors: Vaidya, Ashwinkumar, Polavarapu, Isha, Prabhu, Ravindra, Mohan, Ganesh, Shastry, Shamee, Prethika, P
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-07-2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Analysis; atypical hemolytic uremic syndrome; Blood clots; Blood transfusions; Brief Communication; cascade plasmapheresis; Case reports; Evidence-based medicine; Health aspects; Kidneys; Pathogenesis; Plasma; Plasma exchange (Therapeutics); thrombotic microangiopathy; Vein & artery diseases; Atypical hemolytic uremic syndrome; cascade plasmapheresis; thrombotic microangiopathy
• ISSN: 0973-6247; 1998-3565
• DOI: 10.4103/ajts.ajts_121_21

Atypical hemolytic uremic syndrome (aHUS) is a rare and life-threatening disease that is associated with high mortality and morbidity. The incidence of aHUS is about 1 or 2 cases per 1,000,000 per year. Etiology can be either familial or sporadic. The pathogenesis of aHUS involves dysregulation of the alternative complement pathway, with predisposing mutations in complement genes. aHUS has a poor prognosis and a gradual or a relapsing (30%-86%) clinical course. The disease may present at any age but is mostly seen in children and young adults. Therapeutic plasma exchange (TPE) is one of the primary modalities of treatment in aHUS. This report presents the utilization of cascade plasmapheresis and its advantages over TPE in a patient with relapsed aHUS. There was a 73% decrement in antifactor H antibody levels following cascade plasmapheresis.