Pregnancy in Women with Atypical Hemolytic Uremic Syndrome

Overview

Journal Nephron

Publisher Karger

Specialty Nephrology

Date 2021 Sep 13

PMID 34515154

Citations 5

Authors

Eric Rondeau

Gianluigi Ardissino

Marie-Pierre Caby-Tosi

Imad Al-Dakkak

Fadi Fakhouri

Benjamin Miller

Marie Scully

Affiliations

Soon will be listed here.

Abstract

Background: Pregnancy outcomes in patients with atypical hemolytic uremic syndrome (aHUS) are not well-documented. Here, we present characteristics of and outcomes for patients with aHUS who became pregnant while enrolled in the Global aHUS Registry.

Methods: The observational Global aHUS Registry (NCT01522183), initiated in April 2012, collects demographics, disease history, treatment, and outcomes data for patients with aHUS, regardless of treatment approach. This descriptive analysis includes patients from the Registry with evaluable pregnancy data supplemented with pharmacovigilance information; the number of pregnancies, outcomes, and exposure to eculizumab were evaluated.

Results: As of April 1, 2019, 44 pregnancies were recorded in 41 patients, with 24 pregnancies exposed to eculizumab. Pathogenic variants were identified in 48.8% of patients. Three patients were on dialysis and 6 patients had a kidney graft at the time of pregnancy. Excluding elective terminations, 85.3% of pregnancies resulted in live births. Elective terminations were recorded in 22.7% of pregnancies, miscarriages occurred in 9.1% of pregnancies, and late fetal death in 2.3% of pregnancies. No malformations or anomalies were reported.

Conclusions: Our results show that in women with aHUS, even on dialysis or with a kidney graft, pregnancy is possible with careful monitoring for aHUS flares and prematurity. Prophylactic or therapeutic eculizumab offers disease control with low-risk of fetal abnormalities.

Citing Articles

Kidney and pregnancy outcomes in pregnancy-associated atypical hemolytic uremic syndrome: A systematic review and meta-analysis.

Meena P, Gala R, Das R, Bhargava V, Saivani Y, Panda S Medicine (Baltimore). 2025; 104(5):e41403.

PMID: 39889176 PMC: 11789862. DOI: 10.1097/MD.0000000000041403.

Hematologic Complications of Pregnancy.

Patel P, Patel N, Hedges M, Benson A, Tomer A, Lo J Eur J Haematol. 2025; 114(4):596-614.

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Thrombotic Microangiopathy in Pregnancy: Current Understanding and Management Strategies.

Urra M, Lyons S, Teodosiu C, Burwick R, Java A Kidney Int Rep. 2024; 9(8):2353-2371.

PMID: 39156177 PMC: 11328568. DOI: 10.1016/j.ekir.2024.05.016.

Pregnancy-Associated Atypical Hemolytic Uremic Syndrome: A Case Report with Gene Mutation and Successful Eculizumab Treatment.

Dominguez-Vargas A, Arino F, Silva D, Gonzalez-Torres H, Aroca-Martinez G, Egea E AJP Rep. 2024; 14(1):e96-e100.

PMID: 38384402 PMC: 10881257. DOI: 10.1055/a-2164-8438.

Update on the diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) - revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part II: Attack therapy and long-term management.

Kumpfel T, Giglhuber K, Aktas O, Ayzenberg I, Bellmann-Strobl J, Haussler V J Neurol. 2023; 271(1):141-176.

PMID: 37676297 PMC: 10770020. DOI: 10.1007/s00415-023-11910-z.

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