Pregnancy-Associated Atypical Hemolytic Uremic Syndrome Successfully Treated with Ravulizumab: A Case Report

TL;DR

A 31-year-old woman with pregnancy-associated atypical hemolytic-uremic syndrome improved after treatment with ravulizumab, recovering kidney function and avoiding long-term dialysis.

Contribution

This case report demonstrates the successful use of ravulizumab in treating pregnancy-associated atypical hemolytic-uremic syndrome.

Findings

Ravulizumab treatment led to increased platelet count and improved kidney function in the patient.

The patient was discharged after 28 days of treatment and no longer required hemodialysis.

Early administration of ravulizumab may improve clinical outcomes in p-aHUS, similar to eculizumab.

Abstract

Pregnancy-associated atypical hemolytic-uremic syndrome (p-aHUS) refers to a pregnancy that leads to thrombotic microangiopathy (TMA). This disease is associated with adverse maternal outcomes. We encountered a case of p-aHUS, in which treatment with ravulizumab, a long-acting C5 inhibitor, resulted in a favorable clinical course and recovery of renal function. The patient was a 31-year-old woman with no apparent medical history. She developed TMA on the third postpartum day and was initially treated with steroids, plasma exchange, and hemodialysis (HD). On the seventh day of treatment initiation, she was diagnosed with p-aHUS, and treatment with ravulizumab was started. Following administration, her platelet count increased, and her acute kidney injury improved. Consequently, HD was discontinued after six sessions, and the patient was discharged on the 28th day of treatment initiation and continued her recovery at home. Similar to eculizumab, ravulizumab is an effective treatment for p-aHUS. Early administration of ravulizumab after diagnosis of p-aHUS may contribute to favorable clinical outcomes and recovery of renal function, as observed in the present case.

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