Eculizumab hepatotoxicity in pediatric aHUS.

Hayes, Wesley; Tschumi, Sibylle; Ling, Simon C; Feber, Janusz; Kirschfink, Michael; Licht, Christoph (2015). Eculizumab hepatotoxicity in pediatric aHUS. Pediatric nephrology, 30(5), pp. 775-781. Springer 10.1007/s00467-014-2990-5

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BACKGROUND Eculizumab is a humanized anti-C5 antibody approved for the treatment of atypical hemolytic uremic syndrome (aHUS). Its use is increasing in children following reports of its safety and efficacy. METHODS We reviewed biochemical and clinical data related to possible drug-induced liver injury in 11 children treated with eculizumab for aHUS in a single center. RESULTS Elevated aminotransferases were observed in 7 children aged 6 to 11 years following eculizumab treatment for aHUS. Internationally accepted liver enzyme thresholds for drug-induced liver injury were exceeded in 5 cases. In all cases, liver injury was classified as mixed hepatocellular and cholestatic. Infectious and other causes were excluded in each case. One patient with no pre-existing liver disease developed tender hepatomegaly and liver enzyme derangement exceeding 20 times the upper limit of normal following initiation of eculizumab. Recurrent liver injury following re-challenge with eculizumab necessitated its discontinuation and transition to plasma therapy. CONCLUSIONS Hepatotoxicity in association with eculizumab is a potentially important yet previously unreported adverse event. We recommend monitoring liver enzymes in all patients receiving eculizumab. Further research is required to clarify the impact of this adverse event, to characterize the mechanism of potential hepatotoxicity, and to identify which patients are most at risk.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Nephrology

UniBE Contributor:

Tschumi, Sibylle

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0931-041X

Publisher:

Springer

Language:

English

Submitter:

André Schaller

Date Deposited:

27 Jan 2015 16:48

Last Modified:

29 Oct 2015 10:15

Publisher DOI:

10.1007/s00467-014-2990-5

PubMed ID:

25416628

BORIS DOI:

10.7892/boris.62195

URI:

https://boris.unibe.ch/id/eprint/62195

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