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Hemolytic Uremic Syndrome, Genetic

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Glomerulonephritis

Abstract

The nomenclature of atypical hemolytic uremic syndrome (aHUS) has undergone an evolution as rapid as the scientific understanding of the field during the last decade. Identification of many underlying genetic causes has increased understanding of the major mechanisms of disease. These defects principally, but not exclusively, involve the alternative pathway of complement. Important differences among the specific defects have impact on disease management, and clinical genetics plays a key role in that process. Untreated, aHUS frequently leads to end stage renal disease or death. Fortunately, understanding the major disease mechanisms has allowed development of effective treatment options.

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References

  • Azukaitis K, Simkova E, Majid MA, Galiano M, Benz K, Amann K et al (2017) The phenotypic spectrum of nephropathies associated with mutations in diacylglycerol kinase epsilon. J Am Soc Nephrol 28(10):3066–3075

    Article  PubMed  Google Scholar 

  • Beck BB, van Spronsen F, Diepstra A, Berger RM, Komhoff M (2017) Renal thrombotic microangiopathy in patients with cblC defect: review of an under-recognized entity. Pediatr Nephrol 32:733–741. 2016 Jun 11

    Article  PubMed  Google Scholar 

  • Benamu E, Montoya JG (2016) Infections associated with the use of eculizumab: recommendations for prevention and prophylaxis. Curr Opin Infect Dis 29(4): 319–329

    Article  CAS  PubMed  Google Scholar 

  • Berger BE (2016) The alternative pathway of complement and the evolving clinical-pathophysiological Spectrum of atypical hemolytic uremic syndrome. Am J Med Sci 352(2):177–190

    Article  PubMed  Google Scholar 

  • Bresin E, Rurali E, Caprioli J, Sanchez-Corral P, Fremeaux-Bacchi V, Rodriguez de Cordoba S et al (2013) Combined complement gene mutations in atypical hemolytic uremic syndrome influence clinical phenotype. J Am Soc Nephrol 24(3):475–486

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brown JH, Tellez J, Wilson V, Mackie IJ, Scully M, Tredger MM et al (2012) Postpartum aHUS secondary to a genetic abnormality in factor H acquired through liver transplantation. Am J Transplant 12(6): 1632–1636

    Article  CAS  PubMed  Google Scholar 

  • Coppo R, Bonaudo R, Peruzzi RL, Amore A, Brunati A, Romagnoli R et al (2016) Liver transplantation for aHUS: still needed in the eculizumab era? Pediatr Nephrol 31(5):759–768

    Article  PubMed  Google Scholar 

  • Durey MA, Sinha A, Togarsimalemath SK, Bagga A (2016) Anti-complement-factor H-associated glomerulopathies. Nat Rev Nephrol 12(9):563–578

    Article  CAS  PubMed  Google Scholar 

  • Feng S, Eyler SJ, Zhang Y, Maga T, Nester CM, Kroll MH et al (2013) Partial ADAMTS13 deficiency in atypical hemolytic uremic syndrome. Blood 122(8):1487–1493

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fremeaux-Bacchi V, Arzouk N, Ferlicot S, Charpentier B, Snanoudj R, Durrbach A (2007) Recurrence of HUS due to CD46/MCP mutation after renal transplantation: a role for endothelial microchimerism. Am J Transplant 7(8):2047–2051

    Article  CAS  PubMed  Google Scholar 

  • Fremeaux-Bacchi V, Fakhouri F, Garnier A, Bienaime F, Dragon-Durey MA, Ngo S et al (2013) Genetics and outcome of atypical hemolytic uremic syndrome: a nationwide French series comparing children and adults. Clin J Am Soc Nephrol 8(4):554–562

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • George JN, Nester CM (2014) Syndromes of thrombotic microangiopathy. N Engl J Med 371(7):654–666

    Article  CAS  PubMed  Google Scholar 

  • Goodship TH, Cook HT, Fakhouri F, Fervenza FC, Fremeaux-Bacchi V, Kavanagh D et al (2017) Atypical hemolytic uremic syndrome and C3 glomerulopathy: conclusions from a “Kidney disease: improving global outcomes” (KDIGO) controversies conference. Kidney Int 91:539–551. 2016 Dec 15

    Article  CAS  PubMed  Google Scholar 

  • Greenbaum L (2016) The physician’s guide to atypical hemolytic uremic syndrome (aHUS). In: (NORD) NOfRD, editor. http://www.nordphysicianguidesorg/wp-content/uploads/2015/12/NORD_Physician%E2%80%99s-Guide-to-AHUS.pdf

  • Gurjar BS, Sriharsha TM, Bhasym A, Prabhu S, Puraswani M, Khandelwal P, et al (2018) Characterization of genetic predisposition and autoantibody profile in atypical hemolytic uremic syndrome. Immunology. https://doi.org/10.1111/imm.12916. [Epub ahead of print]. PMID:29485195

  • Hirt-Minkowski P, Dickenmann M, Schifferli JA (2010) Atypical hemolytic uremic syndrome: update on the complement system and what is new. Nephron Clin Pract 114(4):c219–c235

    Article  PubMed  Google Scholar 

  • Kavanagh D, Goodship T (2010) Genetics and complement in atypical HUS. Pediatr Nephrol 25(12): 2431–2442

    Article  PubMed  PubMed Central  Google Scholar 

  • Kavanagh D, Goodship TH, Richards A (2013) Atypical hemolytic uremic syndrome. Semin Nephrol 33(6): 508–530

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Legendre CM, Licht C, Muus P, Greenbaum LA, Babu S, Bedrosian C et al (2013) Terminal complement inhibitor eculizumab in atypical hemolytic-uremic syndrome. N Engl J Med 368(23):2169–2181

    Article  CAS  PubMed  Google Scholar 

  • Lemaire M, Fremeaux-Bacchi V, Schaefer F, Choi M, Tang WH, Le Quintrec M et al (2013) Recessive mutations in DGKE cause atypical hemolytic-uremic syndrome. Nat Genet 45(5):531–536

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Loirat C, Fremeaux-Bacchi V (2011) Atypical hemolytic uremic syndrome. Orphanet J Rare Dis 6:60

    Article  PubMed  PubMed Central  Google Scholar 

  • Loirat C, Fremeaux-Bacchi V (2014) Anti-factor H autoantibody-associated hemolytic uremic syndrome: the earlier diagnosed and treated, the better. Kidney Int 85(5):1019–1022

    Article  PubMed  Google Scholar 

  • Loirat C, Saland J, Bitzan M (2012) Management of hemolytic uremic syndrome. Presse Med 41(3 Pt 2):e115–e135

    Article  PubMed  Google Scholar 

  • Loirat C, Fakhouri F, Ariceta G, Besbas N, Bitzan M, Bjerre A et al (2016) An international consensus approach to the management of atypical hemolytic uremic syndrome in children. Pediatr Nephrol 31(1): 15–39

    Article  Google Scholar 

  • Malina M, Roumenina LT, Seeman T, Le Quintrec M, Dragon-Durey MA, Schaefer F et al (2012) Genetics of hemolytic uremic syndromes. Presse Med 41(3 Pt 2):e105–e114

    Article  PubMed  Google Scholar 

  • Murphy K (2008) Janeway’s immunobiology, 7th edn. Garland Science, New York

    Google Scholar 

  • Nester CM, Barbour T, de Cordoba SR, Dragon-Durey MA, Fremeaux-Bacchi V, Goodship TH et al (2015) Atypical aHUS: state of the art. Mol Immunol 67(1): 31–42

    Article  CAS  PubMed  Google Scholar 

  • Nishimura J, Yamamoto M, Hayashi S, Ohyashiki K, Ando K, Brodsky AL et al (2014) Genetic variants in C5 and poor response to eculizumab. N Engl J Med 370(7):632–639

    Article  CAS  PubMed  Google Scholar 

  • Noris M, Remuzzi G (2013) Overview of complement activation and regulation. Semin Nephrol 33(6): 479–492

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Osborne AJ, Breno M, Borsa NG, Bu F, Fremeaux-Bacchi V, Gale DP et al (2018) Statistical validation of rare complement variants provides insights into the molecular basis of atypical hemolytic uremic syndrome and C3 glomerulopathy. J Immunol 200:2464–2478. 2018 Mar 2

    Article  CAS  PubMed  Google Scholar 

  • Picard C, Burtey S, Bornet C, Curti C, Montana M, Vanelle P (2015) Pathophysiology and treatment of typical and atypical hemolytic uremic syndrome. Pathol Biol 63(3):136–143

    Article  CAS  PubMed  Google Scholar 

  • Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J et al (2015) Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 17(5):405–424

    Article  PubMed  PubMed Central  Google Scholar 

  • Saland J (2014) Liver-kidney transplantation to cure atypical HUS: still an option post-eculizumab? Pediatr Nephrol 29(3):329–332

    Article  PubMed  Google Scholar 

  • Saland JM, Ruggenenti P, Remuzzi G, Consensus Study G (2009) Liver-kidney transplantation to cure atypical hemolytic uremic syndrome. J Am Soc Nephrol 20(5):940–949

    Article  CAS  PubMed  Google Scholar 

  • Saland J, Satlin L, Zalsos-Johnson J, Cremers S, Ginsberg H (2016) Impaired postprandial lipemic response in chronic kidney disease. Kidney Int 90:172–180. in press

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Vieira-Martins P, El Sissy C, Bordereau P, Gruber A, Rosain J, Fremeaux-Bacchi V (2016) Defining the genetics of thrombotic microangiopathies. Transfus Apher Sci 54(2):212–219

    Article  PubMed  Google Scholar 

  • Yuksel S, Evrengul H, Ozcakar ZB, Becerir T, Yalcin N, Korkmaz E et al (2016) First-line, early and long-term eculizumab therapy in atypical hemolytic uremic syndrome: a case series in pediatric patients. Paediatr Drugs 18(6):413–420

    Article  PubMed  Google Scholar 

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Correspondence to Jeffrey M. Saland .

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Reyes, L.C., Saland, J.M. (2018). Hemolytic Uremic Syndrome, Genetic. In: Trachtman, H., Hogan, J., Herlitz, L., Lerma, E. (eds) Glomerulonephritis. Springer, Cham. https://doi.org/10.1007/978-3-319-27334-1_43-1

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  • DOI: https://doi.org/10.1007/978-3-319-27334-1_43-1

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  • Print ISBN: 978-3-319-27334-1

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