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


DOI: https://dx.doi.org/10.18565/nephrology.2023.2.49-56

Chuev N.V., Frolova N.F., Iskhakov R.T., Usatyuk S.S., Terentyeva N.V.

1) City Clinical Hospital № 52 of the Moscow Healthcare Department, Moscow, Russia; 2) A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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.
Keywords: Eculizumab, systemic lupus erythematosus, lupus nephritis, thrombotic microangiopathy
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About the Autors

Nikita V. Chuev – Intensivist at the Intensive Care Unit № 2 for Nephrological Patients, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182; e-mail: nchuev@my.com. ORCID 0009-0007-1208-6402.
Nadiya F. Frolova – Cand. Sci (Med.), Associate Professor at the Department of Nephrology, A.I. Yevdokimov Moscow State Medical University. Address: Bldg. 4, 1A Kuskovskaya st., Moscow, 111398; Deputy Chief Physician for Nephrological Care, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182; e-mail: nadiya.frolova@yandex.ru. ORCID: http://orcid.org/0000-0002-6086-5220.
Rustam T. Iskhakov – Head of the Intensive Care Unit № 2 for Nephrological Patients, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182; e-mail: stamius@yandex.ru. ORCID: 0000-0003-2850-4465.
Sergey S. Usatyuk – Head of the Nephrology Department №2, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182. E-mail: usatuk-doc@mail.ru. ORCID: 0000-0002-8742-3860
Natalya V. Terentyeva – Nephrologist, Nephrology Department №2, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182. E-mail: natterentyeva14@mail.ru. ORCID: 0000-0003-0614-8076


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