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Pediatric Nephrology

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01.05.2015 | Original Article

Eculizumab hepatotoxicity in pediatric aHUS

verfasst von: Wesley Hayes, Sibylle Tschumi, Simon C. Ling, Janusz Feber, Michael Kirschfink, Christoph Licht

Erschienen in: Pediatric Nephrology | Ausgabe 5/2015

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Abstract

Background

Eculizumab is a humanized anti-C5 antibody approved for the treatment of atypical hemolytic uremic syndrome (aHUS). Its use is increasing in children following reports of its safety and efficacy.

Methods

We reviewed biochemical and clinical data related to possible drug-induced liver injury in 11 children treated with eculizumab for aHUS in a single center.

Results

Elevated aminotransferases were observed in 7 children aged 6 to 11 years following eculizumab treatment for aHUS. Internationally accepted liver enzyme thresholds for drug-induced liver injury were exceeded in 5 cases. In all cases, liver injury was classified as mixed hepatocellular and cholestatic. Infectious and other causes were excluded in each case. One patient with no pre-existing liver disease developed tender hepatomegaly and liver enzyme derangement exceeding 20 times the upper limit of normal following initiation of eculizumab. Recurrent liver injury following re-challenge with eculizumab necessitated its discontinuation and transition to plasma therapy.

Conclusions

Hepatotoxicity in association with eculizumab is a potentially important yet previously unreported adverse event. We recommend monitoring liver enzymes in all patients receiving eculizumab. Further research is required to clarify the impact of this adverse event, to characterize the mechanism of potential hepatotoxicity, and to identify which patients are most at risk.

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Titel: Eculizumab hepatotoxicity in pediatric aHUS
verfasst von: Wesley Hayes
Sibylle Tschumi
Simon C. Ling
Janusz Feber
Michael Kirschfink
Christoph Licht
Publikationsdatum: 01.05.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 5/2015
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-2990-5

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Springer Medizin

Eculizumab hepatotoxicity in pediatric aHUS

Abstract

Background

Methods

Results

Conclusions

Neu im Fachgebiet Pädiatrie

Klimaschutz beginnt bei der Wahl des Inhalators

Embryotransfer erhöht womöglich Leukämierisiko der Kinder

Darf man die Behandlung eines Neonazis ablehnen?

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Pädiatrie

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

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