The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 1
Atypical Hemolytic Uremic Syndrome due to Factor H Autoantibody
Division of Pediatric Nephrology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey.
E-mail: arifeuslu2001@yahoo.com
Atypical hemolytic uremic syndrome (aHUS) is a disease caused by pathologies
in the alternative complement system. The prevalence of aHUS is 10% of
all aHUS cases. The subgroup of aHUS designated as DEAP (DEficiency of
CFHR Proteins and CFH Autoantibody Positive)-HUS because of autoantibody
to complement factor H (CFH) and CFH-related protein deficiency is seen
very rarely, and the prevalence is 6% of all aHUS cases in the literature.
We present here a female patient with DEAP-HUS. A 7.5-year-old girl with
recurrent attacks of HUS had low C3 level. We initiated plasmapheresis
treatment. After further analysis of the complement system, the result was
compatible with DEAP-HUS, so we initiated immunosuppressive treatment.
There were also family members with deficiency of CFHR-1 and CFHR-3,
but they had no CFH autoantibody and no symptoms of HUS. In atypical
cases of HUS, we should investigate complement status, especially for factor
H autoantibody, for which treatment options differ from those of the other
types of aHUS.
Keywords :
atypical hemolytic uremic syndrome, complement, autoantibody, complement
factor H, complement factor H-related protein.