Plasma Therapy in aHUS Patient with SARS-CoV-2 Infection

Introduction

Atypical Hemolytic Uremic Syndrome (aHUS) is a rare condition characterized by complement-mediated thrombotic microangiopathy. Patients with aHUS who contract SARS-CoV-2 face a heightened risk of disease recurrence due to complement system activation. However, the management of such cases remains an area of ongoing research. This article explores a recent case study where convalescent plasma therapy was successfully administered to a patient with aHUS and SARS-CoV-2 infection.

Case Summary

A 52-year-old female with a history of aHUS, previously managed with kidney transplantation and hemodialysis, presented with symptoms of SARS-CoV-2 infection, including fever, diarrhea, and asthenia. Laboratory tests confirmed the infection, and she was admitted to the SARS-CoV-2 Unit of the Polyclinic of Bari.

Key Findings:

  • Initial Treatment: The patient received azithromycin, dexamethasone, and enoxaparin.
  • Disease Progression: Her condition worsened, leading to respiratory distress requiring ICU support.
  • Plasma Therapy Intervention:
    • Three doses of convalescent plasma (250ml each) were administered.
    • Oxygenation levels (PO2/FiO2 ratio) improved significantly after the second infusion.
    • Inflammatory markers showed a notable decline post-therapy.
  • Outcome:
    • The patient recovered without developing aHUS recurrence.
    • She was discharged 55 days after the initial SARS-CoV-2 diagnosis.

Broader Medical Implications

The American Society of Hematology highlights the role of plasma therapy in severe viral infections, emphasizing its potential to neutralize pathogens and modulate immune responses. While convalescent plasma therapy remains under investigation for SARS-CoV-2, this case underscores its potential as a rescue treatment in patients with underlying complement-mediated disorders.

Study Reference & Links

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Conclusion

This case highlights the potential benefits of convalescent plasma therapy in managing SARS-CoV-2 infections in aHUS patients. More research is needed to validate these findings and establish treatment guidelines.