Acute Myocarditis and Eculizumab Caused Severe Cholestasis in a 17-Month-Old Child Who Has Hemolytic Uremic Syndrome Associated with Shiga Toxin-Producing Escherichia coli

YEŞİLBAŞ O., Yozgat C. Y., AKINCI N., SÖNMEZ Ş., TEKİN E., TALEBAZADEH F., ...Daha Fazla

JOURNAL OF PEDIATRIC INTENSIVE CARE, cilt.10, sa.3, ss.216-220, 2021 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 10 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1055/s-0040-1713111
  • Dergi Adı: JOURNAL OF PEDIATRIC INTENSIVE CARE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), EMBASE
  • Sayfa Sayıları: ss.216-220
  • Anahtar Kelimeler: hemolytic uremic syndrome, myocarditis, eculizumab, therapeutic plasma exchange, HEPATOTOXICITY
  • Bezmiâlem Vakıf Üniversitesi Adresli: Evet

Özet

Cardiovascular involvement is uncommon in pediatric patients with hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC-HUS). In this case report we presented a case of 17-month-old toddler who had a sporadic type of STEC-HUS complicated by acute myocarditis. The patient was successfully treated by a single dose of eculizumab after six doses of therapeutic plasma exchange (TPE) were inefficient to prevent the cardiac complication. Hepatotoxicity was observed after a single dose of eculizumab. Hepatic and cholestatic enzyme levels slowly returned to normal within 6 months. To the best of our knowledge, this is the first case of myocarditis/cardiomyopathy treated with eculizumab in STEC-HUS. This case illustrates the need for vigilance regarding myocardial involvement and eculizumab-induced hepatotoxicity in STEC-HUS.