The use of eculizumab in Capnocytophaga canimorsus associated thrombotic microangiopathy: a case report.
BMC Infect Dis
; 21(1): 137, 2021 Feb 01.
Article
in En
| MEDLINE
| ID: mdl-33526010
ABSTRACT
BACKGROUND:
The use of complement inhibition is well established for complement mediated thrombotic microangiopathy, but its role in secondary forms of thrombotic microangiopathy is debated. We here present a case of thrombotic microangiopathy triggered by Capnocytophaga canimorsus, illustrating the diagnostic difficulties in discriminating between different thrombotic microangiopathies, and the dilemmas regarding how to treat this disease entity. CASE PRESENTATION A previously healthy 56-year-old woman presented with fever and confusion. She was diagnosed with sepsis from Capnocytophaga canimorsus and thrombotic microangiopathy. Marked activation of both T-cells, endothelium and complement were documented. She was successfully treated with antimicrobial therapy, the complement inhibitor eculizumab and splenectomy. After several weeks, a heterozygote variant in complement factor B was localized, potentially implying the diagnosis of a complement mediated TMA over an isolated infection related TMA.CONCLUSIONS:
We discuss the possible interactions between complement activation and other findings in severe infection and argue that complement inhibition proved beneficial to this patient's rapid recovery.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Capnocytophaga
/
Complement Activation
/
Complement Inactivating Agents
/
Thrombotic Microangiopathies
/
Antibodies, Monoclonal, Humanized
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
BMC Infect Dis
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2021
Document type:
Article
Affiliation country: