Experience with the use of eculizumab in the treatment of thrombotic microangiopathy in a patient with systemic lupus erythematosus

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Abstract

Background. Thrombotic microangiopathy (TMA) is a clinical and morphological syndrome, which is characterized by endothelial dysfunction of the vessels of the microvasculature with their inflammation, the development of generalized thrombosis, resulting in organ failure. Systemic lupus erythematosus is one of the risk factors for the development of complement-mediated TMA, including in patients with lupus nephritis. The rate of partial or complete recovery of renal function in lupusnephritis is only 44%, indicating the need to look for alternative approaches to therapy.

Description of the clinical case. This clinical case represents the experience of successful use of the complement system inhibitor eculizumab in the treatment of complement-mediated TMA associated with lupus nephritis, refractory to plasma exchange, glucocorticosteroids, and previous immunomodulatory therapy.

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About the authors

Nikita V. Chuev

City Clinical Hospital № 52 of the Moscow Healthcare Department

Author for correspondence.
Email: nchuev@my.com
ORCID iD: 0009-0007-1208-6402

Intensivist at the Intensive Care Unit № 2 for Nephrological Patients, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Nadiya F. Frolova

City Clinical Hospital № 52 of the Moscow Healthcare Department; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: nadiya.frolova@yandex.ru
ORCID iD: 0000-0002-6086-5220

Cand. Sci (Med.), Associate Professor at the Department of Nephrology, A.I. Yevdokimov Moscow State Medical University; Deputy Chief Physician for Nephrological Care, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow; Moscow

Rustam T. Iskhakov

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: stamius@yandex.ru
ORCID iD: 0000-0003-2850-4465

Head of the Intensive Care Unit № 2 for Nephrological Patients, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Sergey S. Usatyuk

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: usatuk-doc@mail.ru
ORCID iD: 0000-0002-8742-3860

Head of the Nephrology Department №2, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Natalya V. Terentyeva

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: natterentyeva14@mail.ru
ORCID iD: 0000-0003-0614-8076

Nephrologist, Nephrology Department №2, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

References

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. TMA classification

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3. Fig. 2. Kidney biopsy results

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4. Fig. 3. Signs of an episode of gastrointestinal bleeding

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5. Fig. 4. Results of a biopsy of the appendix

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6. Fig. 5. Dynamics of platelet and hemoglobin levels during treatment

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