Deficiency of complement factor H-related proteins and autoantibody-positive hemolytic uremic syndrome in an infant with combined partial deficiencies and autoantibodies to complement factor H and ADAMTS13

Mini Michael, Nancy Turner, Ewa Elenberg, Linda G. Shaffer, Jun Teruya, Mazen Arar, Shiu Ki Hui, Richard J. Smith, Joel Moake

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

A 3-month-old male infant developed an extremely severe episode of atypical hemolytic uremic syndrome (aHUS) associated with partial deficiencies of full-length complement factor H (FH; 15% of infant normal) and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) (39% of normal) and autoantibodies reactive with both proteins. His FH and ADAMTS13 genes were normal, indicating that the partial deficiencies were acquired, probably as the result of autoantibodies against full-length FH and ADAMTS13. The child also had a homozygous deletion of the complement factor H–related (CFHR)3–CFHR1 portion in the complement factor H (CFH) gene cluster. He therefore had deficiency of CFHR proteins and autoantibody-positive hemolytic uremic syndrome (DEAP-HUS) with an unusual early onset associated with a partial deficiency of ADAMTS13 and an anti-ADAMTS13 autoantibody. His clinical episode of aHUS responded to plasma infusion and subsequent treatment with mycophenolate and rituximab. We believe that this is the first report of DEAP-HUS in an infant with partial deficiencies in both ADAMTS13 and full-length FH acquired in association with autoantibodies to both proteins.

Original languageEnglish (US)
Pages (from-to)791-796
Number of pages6
JournalClinical Kidney Journal
Volume11
Issue number6
DOIs
StatePublished - 2018

Keywords

  • Acute kidney injury
  • Atypical HUS
  • Autoantibody to ADAMTS13
  • Factor H autoantibody
  • Thrombotic microangiopathy

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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