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Eculizumab treatment in severe pediatric STEC-HUS: a multicenter retrospective study

dc.rights.licenseopenen_US
dc.contributor.authorPERCHERON, L.
dc.contributor.authorGRAMADA, R.
dc.contributor.authorTELLIER, S.
dc.contributor.authorSALOMON, R.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorHARAMBAT, Jerome
IDREF: 110567358
dc.contributor.authorLLANAS, B.
dc.contributor.authorFILA, M.
dc.contributor.authorALLAIN-LAUNAY, E.
dc.contributor.authorLAPEYRAQUE, A. L.
dc.contributor.authorLEROY, V.
dc.contributor.authorADRA, A. L.
dc.contributor.authorBERARD, E.
dc.contributor.authorBOURDAT-MICHEL, G.
dc.contributor.authorCHEHADE, H.
dc.contributor.authorECKART, P.
dc.contributor.authorMERIEAU, E.
dc.contributor.authorPIETREMENT, C.
dc.contributor.authorSELLIER-LECLERC, A. L.
dc.contributor.authorFREMEAUX-BACCHI, V.
dc.contributor.authorDIMEGLIO, C.
dc.contributor.authorGARNIER, A.
dc.date.accessioned2020-12-14T13:15:40Z
dc.date.available2020-12-14T13:15:40Z
dc.date.issued2018-08
dc.identifier.issn1432-198X (Electronic) 0931-041X (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/21440
dc.description.abstractEnBACKGROUND: Hemolytic uremic syndrome related to Shiga-toxin-secreting Escherichia coli infection (STEC-HUS) remains a common cause of acute kidney injury in young children. No specific treatment has been validated for this severe disease. Recently, experimental studies highlight the potential role of complement in STEC-HUS pathophysiology. Eculizumab (EC), a monoclonal antibody against terminal complement complex, has been used in severe STEC-HUS patients, mostly during the 2011 German outbreak, with conflicting results. METHODS: On behalf of the French Society of Pediatric Nephrology, we retrospectively studied 33 children from 15 centers treated with EC for severe STEC-HUS. Indication for EC was neurologic involvement in 20 patients, cardiac and neurologic involvement in 8, cardiac involvement in 2, and digestive involvement in 3. Based on medical status at last follow-up, patients were divided into two groups: favorable (n = 15) and unfavorable outcomes (n = 18). RESULTS: Among patients with favorable outcome, 11/14 patients (79%) displayed persistent blockade of complement activity before each EC reinjection. Conversely, in patients with unfavorable outcome, only 9/15 (53%) had persistent blockade (p = n.s.). Among 28 patients presenting neurological symptoms, 19 had favorable neurological outcome including 17 with prompt recovery following first EC injection. Only two adverse effects potentially related to EC treatment were reported. CONCLUSIONS: Taken together, these results may support EC use in severe STEC-HUS patients, especially those presenting severe neurological symptoms. The study, however, is limited by absence of a control group and use of multiple therapeutic interventions in treatment groups. Thus, prospective, controlled trials should be undertaken.
dc.language.isoENen_US
dc.subject.enLEHA
dc.title.enEculizumab treatment in severe pediatric STEC-HUS: a multicenter retrospective study
dc.title.alternativePediatr Nephrolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s00467-018-3903-9en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed29572749en_US
bordeaux.journalPediatric Nephrologyen_US
bordeaux.page1385-1394en_US
bordeaux.volume33en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue8en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamLEHA_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03064565
hal.version1
hal.date.transferred2020-12-14T13:15:48Z
hal.exporttrue
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