COVID TRIGGERS aHUS

It was March 2020 and COVID appears on www.ahusallianceaction.org for first time with a question:

Can the coronavirus trigger an infection TMA?

The newly posted trial on the website ( aHUS Trials Watch 10) seemed to suggest that. AND

If so would those genetically susceptible, who either may never have onset with aHUS, or were in remission from aHUS be at risk of the TMA turning into aHUS?

Questions not specifically answered anywhere at that time , mainly because it would be a rare event. For those with rare diseases lack of information is not unusual.

That was then but now the question has been answered as more information emerges.

Now there is much evidence that “COVID TRIGGERS aHUS“.

As the following 28 COVID aHUS patients ( 13 Women/Girls , 15 Men/Boys ; 7 Children, 21 Adults ) from around the world will testify.

The question now is how many more are , or sadly were , there?

Woman, White, 28 yo Relapse, Nantes France

Ville S, Le Bot S, Chapelet-Debout A, et al. Atypical HUS relapse triggered by COVID-19. Kidney Int. 2021;99(1):267-268. doi:10.1016/j.kint.2020.10.030

Man, Hispanic, 32 yo New Onset , Dallas, USA

Gill J, Hebert CA, Colbert GB. COVID-19-associated atypical hemolytic uremic syndrome and use of Eculizumab therapy. J Nephrol. 2022;35(1):317-321. doi:10.1007/s40620-021-01125-8

Woman, 22 yo New Onset ; Woman, 52 yo New Onset , Hanover , Germany

Atypical Hemolytic and Uremic Syndrome Triggered by Infection With SARS-CoV2 Kaufeld J., Reinhardt M., Schroder C., Brasen J.H., Wiech T., Brylka P., Khaled A., (…), Schmidt B.M.W.(2021)  Kidney International Reports,  6  (10) , pp. 2709-2712.

Man, 66 yo; Man, 71 yo; Man, 35 yo; Woman, 26 yo; Woman 38 yo, All New Onsets , France

Sissy et al COVID-19 as a potential trigger of complement-mediated atypical HUS Blood (2021) 138 (18): 1777–1782.

Man, 39 yo,, New Onset, Brussels. Belgium

Mat O, Ghisdal L, Massart A, et al. Kidney Thrombotic Microangiopathy After COVID-19 Associated With C3 Gene Mutation. Kidney Int Rep. 2021;6(6):1732-1737. doi:10.1016/j.ekir.2021.03.897

Girl, 3 yo , New Onset, Turkey

Thrombotic Microangiopathy in a Severe Pediatric Case of COVID-1 Tahir DalkıranYaşar KandurEmine Manolya KaraBesra DağoğluSevgin TanerDoğan ÖncüFirst Published October 21, 2021 Case Reporthttps://doi.org/10.1177/11795565211049897

Man, Hispanic, 25 yo, Relapse; Woman, White ,31 yo, New Onset, Philadelphia , USA

Kurian, C.J., French, Z., Kukulich, P. et al. Case series: coronavirus disease 2019 infection as a precipitant of atypical hemolytic uremic syndrome: two case reports. J Med Case Reports 15, 587 (2021). https://doi.org/10.1186/s13256-021-03144-2

Boy, 16 months, New Onset, Boston, USA

Alizadeh F, O’Halloran A, Alghamdi A, Chen C, Trissal M, Traum A, DeCourcey D. Toddler With New Onset Diabetes and Atypical Hemolytic-Uremic Syndrome in the Setting of COVID-19. Pediatrics. 2021 Feb;147(2):e2020016774. doi: 10.1542/peds.2020-016774. Epub 2020 Oct 9. PMID: 33037119.

Man, 46 yo New Onset , Paris, France

Boudhabhay I, Rabant M, Roumenina LT, et al. Case Report: Adult Post-COVID-19 Multisystem Inflammatory Syndrome and Thrombotic Microangiopathy. Front Immunol. 2021;12:680567. Published 2021 Jun 23. doi:10.3389/fimmu.2021.680567

Woman, 67 yo , New Onset , Salt lake City , USA

WHY ARE THE PLATELETS GONE? A CASE OF TMA IN COVID-19 Marie Moulton, MD, John Gerstenberger, MD11University of Utah, Division of General Internal Medicine, UT, Salt Lake CityMeeting: SHM Converge 2021Abstract Number: 452

Woman, 47 yo, New Onset,

AKI secondary to atypical hemolytic uremic syndrome caused by COVID-19 Abraham, R. R.Akabane, H..Journal of the American Society of Nephrology ; 32:93, 2021.Artigo em Inglês | EMBASE | ID: covidwho-1489268

Man , 24 yo , Relapse, Buenos Aires, Argentine

Eculizumab, SARS-CoV-2 and atypical hemolytic uremic syndrome Herna´n Trimarchi , Raquel Gianserra, Mauro Lampo, Matias Monkowski and Jimena Lodolo Nephrology Service, Hospital Brita´nico de Buenos Aires, Buenos Aires, Argentina

Boy, 4 yo, New Onset; Boy, 12 yo, Relapse; Boy, 13 yo, Relapse; Boy, 7 yo ,Relapse; Girl 12 yo, New Onset , India

Khandelwal, P., Krishnasamy, S., Govindarajan, S. et al. Anti-factor H antibody associated hemolytic uremic syndrome following SARS-CoV-2 infection. Pediatr Nephrol (2022). https://doi.org/10.1007/s00467-021-05390-4

Woman , 49 yo, Man 39 yo , Woman , 66 yo All New Onsets , Russia

https://www.karger.com/Article/FullText/520144#ref7

if anyone who has experienced COVID triggering aHUS, aHUS alliance Global Action would like to hear your story.

Article No. 486

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