Du médicament psychoactif à l'addictovigilance dans le Code de la sante publique en France (1990-2017)

MADDEN, I.; ROUMENINA, L. T.; LANGLOIS-MEURINNE, H.; GUICHOUX, J.; LLANAS, B.; FREMEAUX-BACCHI, V.; HARAMBAT, Jerome; GODRON-DUBRASQUET, A.

doi:10.1007/s00467-018-4174-1

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MADDEN, I.

ROUMENINA, L. T.

LANGLOIS-MEURINNE, H.

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Pediatric Nephrology. 2019-03, vol. 34, n° 3, p. 533-537

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BACKGROUND: Hemolytic uremic syndrome (HUS) has been associated with a number of infectious agents. We report here the case of an infant with severe Bordetella pertussis infection who developed HUS. CASE DIAGNOSIS/TREATMENT: A 2-month-old preterm male was admitted for severe Bordetella pertussis infection. Symptoms leading to a diagnosis of hemolytic uremic syndrome (HUS) rapidly appeared: hemolytic anemia, thrombocytopenia, and acute kidney injury. He was treated with 25 days of peritoneal dialysis and received complement-targeting therapy with eculizumab (five injections over 2 months), in addition to blood transfusions, antibiotics, and respiratory support. The outcome was favorable. The genetic workup found a complement factor H gene variant which has been associated with atypical HUS. This variant was located in the C3b-binding site and functional tests revealed that it perturbed the regulatory activity of factor H. CONCLUSION: This case suggests that pertussis is a strong trigger of HUS and that complement investigations are necessary to guide treatment and understand the pathophysiology.< Leer menos

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LEHA

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