• J. Pediatr. Hematol. Oncol. · Nov 2018

    Case Reports

    A Heterozygous CFHR3-CFHR1 Gene Deletion in a Pediatric Patient With Transplant-associated Thrombotic Microangiopathy Who was Treated With Eculizumab.

    • Akifumi Nozawa, Michio Ozeki, Tomohiro Hori, Norio Kawamoto, Masahiro Hirayama, Eiichi Azuma, and Toshiyuki Fukao.
    • Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu University, Gifu.
    • J. Pediatr. Hematol. Oncol. 2018 Nov 1; 40 (8): e544-e546.

    AbstractComplement system dysregulation, such as complement Factor H (CFH) autoantibodies and deletions in CFH-related (CFHR) genes 3 and 1, might cause transplant-associated thrombotic microangiopathy (TA-TMA). The use of eculizumab, a terminal complement inhibitor, could be a targeted therapy for TA-TMA. We report a 1-year-old girl who developed TA-TMA, just after autologous peripheral blood stem cell transplantation in neuroblastoma therapy. Eculizumab improved TA-TMA. Investigation for the complement alternative pathway showed a heterozygous CFHR3-CFHR1 gene deletion, which is involved in complement activation. The patient might develop TA-TMA as a result of complement regulatory gene mutation.

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