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Zipfel, Peter F.; Mache, Christoph; Müller, Dominik; Licht, Christoph; Wigger, Marianne; Skerka, Christine
Pediatric nephrology (Berlin, West), 10/2010, Letnik: 25, Številka: 10Journal Article
DEAP-HUS De ficiency of CFHR (complement factor H-related) plasma proteins and A utoantibody P ositive form of H emolytic U remic S yndrome represents a novel subtype of hemolytic uremic syndrome (HUS) with unique characteristics. It affects children and requires special clinical attention in terms of diagnosis and therapy. DEAP-HUS and other atypical forms of HUS share common features, such as microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. However, DEAP-HUS has the unique combination of an acquired factor in the form of autoantibodies to the complement inhibitor Factor H and a genetic factor which, in most cases, is the chromosomal deletion of a 84-kbp fragment within human chromosome 1 that results in the absence of the CFHR1 and CFHR3 proteins in plasma. Special attention is required to diagnose and treat DEAP-HUS patients. Most patients show a favorable response to the reduction of autoantibody titers by either plasma therapy, steroid treatment, and/or immunosuppression. In addition, in those DEAP-HUS patients with end-stage renal disease, the reduction of autoantibody titers prior to transplantation is expected to prevent post-transplant disease recurrence by aiming for full complement control at the endothelial cell surface in order to minimize adverse complement and immune reactions.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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