Patient Characteristics
Patient . | Age (y), sex . | Race . | PLEX . | Dialysis . | Creatinine, mg/dL . | Platelet count, ×103/μL . | LDH, units/L . | Complement abnormality . | Triggering condition . | Eculizumab duration, d . | Time to relapse, d . | Follow-up, d . | Post-cessation follow-up, d . | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Initial . | Chronic . | Admit . | Stop . | Last . | Admit . | Stop . | Last . | Admit . | Stop . | Last . | ||||||||||
1 | 32, F | W | Yes | No | No | 4.6* | — | 1.3 | 70* | — | 88† | 288 | — | 126 | ADAMTS13 Ser1314Leu heterozygous | Liver transplant | >1600* | 90* | 1946 | 350* |
2 | 19, F | L | Yes | Yes | Yes | — | RRT | RRT | — | 114 | 240 | — | 1125 | 311 | DGKE Phe106Leu heterozygous | URI | 49* | N/A | >1440* | 1390* |
3 | 22, F | W | No | Yes | No | 6.3 | 3.78 | 2.58 | 62 | 251 | 233 | 2820 | 195 | 164 | None identified | Unknown | 302 | N/A | 1038 | 736 |
4 | 46, F | W | Yes | No | No | 1.6 | 0.9 | 0.8 | 9 | 327 | 315 | 2505 | 180 | 179 | CFH Gln950His heterozygous, del(CFHR3-CFHR1) homozygous | Nephrolithiasis | 83 | N/A | 1032 | 943 |
5 | 65, F | W | Yes | Yes | No | 8.2 | 1.1 | 1.11 | 24 | 376 | 327 | 2098 | 180 | 200 | CD46 Glu142Gln heterozygous, del(CFHR3-CFHR1) heterozygous | Quinine, quinine antibodies | 32 | N/A | 967 | 931 |
6 | 51, F | W | Yes | No | No | 2.8 | N/A | 1.1 | 13 | N/A | 185 | 1276 | N/A | 143 | del(CFHR3-CFHR1) heterozygous, ADAMTS13 Ala732Val heterozygous | Pancreatitis | 812 | N/A | 814 | 0 |
7 | 64, M | W | Yes | No | No | 2.53 | 1.3 | 1.28 | 66 | 237 | 227 | 1288 | 216 | 141 | Not determined | Gastroenteritis | 98 | N/A | 734 | 615 |
8 | 74, F | W | Yes | Yes | No | 6.1 | 1.3 | 1.08 | 25 | 227 | 258 | — | 168 | — | Not determined | Gastroenteritis | 524 | N/A | 595 | 66 |
9 | 23, F | W | No | Yes | No | 4.3 | 1.29 | 1.2 | — | 227 | 269 | 471 | 162 | 164 | Not determined | Possible scleroderma | 545 | N/A | 586 | 33 |
10 | 69, M | W | Yes | No | No | 2.2 | 1.6 | 1.9 | 24 | 307 | 180 | 676 | 193 | 193 | Not determined | Hodgkin disease relapse | 42 | N/A | 451 | 405 |
11 | 23, F | AA | Yes | Yes | No | 6.9 | 3.3 | 1.18 | 31 | 293 | 207 | 5970 | 133 | 163 | del(CFHR3-CFHR1) homozygous | Postpartum, dental abscess, Stevens-Johnson syndrome | 47 | N/A | 426 | 378 |
12 | 37, F | W | No | No | No | 3.48 | 0.8 | 0.77 | 45 | 383 | 697 | 2501 | 172 | 171 | del (CFH-SCR20-CFHR1-int5) heterozygous, THBD Ala43Thr heterozygous | Inflammatory bowel disease | 357 | 48 | 425 | 48 |
13 | 50, F | W | No | Yes | Yes | 6.5 | RRT | RRT | 80 | 252 | 660 | 903 | 627 | 461 | del(CFHR3-CFHR1) heterozygous | Polymyositis-scleroderma overlap | 177 | N/A | 329 | 152 |
14 | 51, M | W | No | No | No | 3.4 | 1.2 | 1.1 | 18 | 328 | 380 | 5266 | 179 | 170 | CFH Arg1074Pro heterozygous, CD46 820delAG Ser274TyrFS*11 heterozygous, del(CFHR3-CFHR1) heterozygous | URI | 25 | N/A | 264 | 239 |
15 | 24, M | AA | Yes | Yes | No | 12.7 | 2.66 | 2.55 | 94 | 189 | 183 | 649 | 113 | 119 | None identified | Malignant HTN | 167 | N/A | 210 | 38 |
16 | 38, F | AA | Yes | Yes | Yes | 3.1 | N/A | RRT | 81 | N/A | 163 | 514 | N/A | 327 | CFH Val158Ile heterozygous, CFH Ala1027Pro heterozygous, del(CFHR 3-CFHR1) heterozygous, ADAMTS13 Thr1226Ile heterozygous | Unclear, lancosamide and carbamazepine antiplatelet antibodies | 123 | N/A | 128 | 0 |
17 | 47, F | AA | Yes | No | No | 4.3 | 4.3 | 5.91 | 17 | 110 | 30 | 1718 | 290 | 3208 | del(CFHR3-CFHR1) heterozygous, del(CFHR1-CFHR4) heterozygous, CFB Ile242Leu heterozygous | Malignant HTN, nonadherence | 14 | 53 | 96 | 88 |
Patient . | Age (y), sex . | Race . | PLEX . | Dialysis . | Creatinine, mg/dL . | Platelet count, ×103/μL . | LDH, units/L . | Complement abnormality . | Triggering condition . | Eculizumab duration, d . | Time to relapse, d . | Follow-up, d . | Post-cessation follow-up, d . | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Initial . | Chronic . | Admit . | Stop . | Last . | Admit . | Stop . | Last . | Admit . | Stop . | Last . | ||||||||||
1 | 32, F | W | Yes | No | No | 4.6* | — | 1.3 | 70* | — | 88† | 288 | — | 126 | ADAMTS13 Ser1314Leu heterozygous | Liver transplant | >1600* | 90* | 1946 | 350* |
2 | 19, F | L | Yes | Yes | Yes | — | RRT | RRT | — | 114 | 240 | — | 1125 | 311 | DGKE Phe106Leu heterozygous | URI | 49* | N/A | >1440* | 1390* |
3 | 22, F | W | No | Yes | No | 6.3 | 3.78 | 2.58 | 62 | 251 | 233 | 2820 | 195 | 164 | None identified | Unknown | 302 | N/A | 1038 | 736 |
4 | 46, F | W | Yes | No | No | 1.6 | 0.9 | 0.8 | 9 | 327 | 315 | 2505 | 180 | 179 | CFH Gln950His heterozygous, del(CFHR3-CFHR1) homozygous | Nephrolithiasis | 83 | N/A | 1032 | 943 |
5 | 65, F | W | Yes | Yes | No | 8.2 | 1.1 | 1.11 | 24 | 376 | 327 | 2098 | 180 | 200 | CD46 Glu142Gln heterozygous, del(CFHR3-CFHR1) heterozygous | Quinine, quinine antibodies | 32 | N/A | 967 | 931 |
6 | 51, F | W | Yes | No | No | 2.8 | N/A | 1.1 | 13 | N/A | 185 | 1276 | N/A | 143 | del(CFHR3-CFHR1) heterozygous, ADAMTS13 Ala732Val heterozygous | Pancreatitis | 812 | N/A | 814 | 0 |
7 | 64, M | W | Yes | No | No | 2.53 | 1.3 | 1.28 | 66 | 237 | 227 | 1288 | 216 | 141 | Not determined | Gastroenteritis | 98 | N/A | 734 | 615 |
8 | 74, F | W | Yes | Yes | No | 6.1 | 1.3 | 1.08 | 25 | 227 | 258 | — | 168 | — | Not determined | Gastroenteritis | 524 | N/A | 595 | 66 |
9 | 23, F | W | No | Yes | No | 4.3 | 1.29 | 1.2 | — | 227 | 269 | 471 | 162 | 164 | Not determined | Possible scleroderma | 545 | N/A | 586 | 33 |
10 | 69, M | W | Yes | No | No | 2.2 | 1.6 | 1.9 | 24 | 307 | 180 | 676 | 193 | 193 | Not determined | Hodgkin disease relapse | 42 | N/A | 451 | 405 |
11 | 23, F | AA | Yes | Yes | No | 6.9 | 3.3 | 1.18 | 31 | 293 | 207 | 5970 | 133 | 163 | del(CFHR3-CFHR1) homozygous | Postpartum, dental abscess, Stevens-Johnson syndrome | 47 | N/A | 426 | 378 |
12 | 37, F | W | No | No | No | 3.48 | 0.8 | 0.77 | 45 | 383 | 697 | 2501 | 172 | 171 | del (CFH-SCR20-CFHR1-int5) heterozygous, THBD Ala43Thr heterozygous | Inflammatory bowel disease | 357 | 48 | 425 | 48 |
13 | 50, F | W | No | Yes | Yes | 6.5 | RRT | RRT | 80 | 252 | 660 | 903 | 627 | 461 | del(CFHR3-CFHR1) heterozygous | Polymyositis-scleroderma overlap | 177 | N/A | 329 | 152 |
14 | 51, M | W | No | No | No | 3.4 | 1.2 | 1.1 | 18 | 328 | 380 | 5266 | 179 | 170 | CFH Arg1074Pro heterozygous, CD46 820delAG Ser274TyrFS*11 heterozygous, del(CFHR3-CFHR1) heterozygous | URI | 25 | N/A | 264 | 239 |
15 | 24, M | AA | Yes | Yes | No | 12.7 | 2.66 | 2.55 | 94 | 189 | 183 | 649 | 113 | 119 | None identified | Malignant HTN | 167 | N/A | 210 | 38 |
16 | 38, F | AA | Yes | Yes | Yes | 3.1 | N/A | RRT | 81 | N/A | 163 | 514 | N/A | 327 | CFH Val158Ile heterozygous, CFH Ala1027Pro heterozygous, del(CFHR 3-CFHR1) heterozygous, ADAMTS13 Thr1226Ile heterozygous | Unclear, lancosamide and carbamazepine antiplatelet antibodies | 123 | N/A | 128 | 0 |
17 | 47, F | AA | Yes | No | No | 4.3 | 4.3 | 5.91 | 17 | 110 | 30 | 1718 | 290 | 3208 | del(CFHR3-CFHR1) heterozygous, del(CFHR1-CFHR4) heterozygous, CFB Ile242Leu heterozygous | Malignant HTN, nonadherence | 14 | 53 | 96 | 88 |
Patient data shown at the time of presentation (admit), eculizumab cessation (stop), or most recent follow-up (last). Missing data indicated with “—.” Patient 1 attained TMA-event-free status, yet later developed persistent thrombocytopenia attributed to alcoholism and transplant medications without evidence of mechanical hemolysis. Initial dialysis signifies requiring dialysis during the acute episode of aHUS. Chronic dialysis signifies continuation of dialysis at the time of the last follow-up. Patients with relapse who were restarted on eculizumab are not included in obviated dose totals. Median eculizumab treatment duration until cessation was 90.5 days. Total cost of obviated eculizumab doses (2 induction and 422 maintenance) was $13 038 379.
AA, African-American; CFH, complement factor H; CFHR, complement factor H related protein; del, deletion; DGKE, diacylglycerol kinase epsilon; HTN, hypertension; L, Latino; LDH, lactate dehydrogenase; N/A, not applicable; PLEX, plasma exchange; RRT, renal replacement therapy (creatinine thus not reported); THBD, thrombomodulin; URI, upper respiratory illness; W, white.
Data from documentation lacking specific dates.
Thrombocytopenia with alternative etiology.