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Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report.
Kathryn E McGraw1, Amanda P Porter1, Alyssa M Moffitt1
1Mercer University School of Medicine, Savannah, GA.
HCA Healthcare Journal of Medicine
|September 18, 2024
Summary
Influenza B infection can trigger atypical hemolytic uremic syndrome (aHUS), a rare condition. This case highlights a patient with a CD46 mutation experiencing recurrent aHUS after influenza B, emphasizing the need for clinical awareness.
Area of Science:
- Nephrology
- Immunology
- Genetics
Background:
- Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury.
- It often results from complement system overactivation due to genetic mutations, particularly affecting the alternative pathway.
- Influenza B is a rare but documented trigger for aHUS.
Observation:
- A 10-year-old girl with a history of aHUS experienced a recurrent episode following influenza B infection.
- This case is unique due to the recurrence and the rare trigger of influenza B in a patient with a known predisposition.
- Genetic analysis revealed a heterozygous mutation in complement protein CD46.
Findings:
- The patient's CD46 mutation is a known risk factor for aHUS.
- Influenza B infection is rarely implicated as a trigger for aHUS, especially in patients with CD46 mutations.
- Individuals with CD46 mutations often experience high relapse rates but may have less long-term kidney damage.
Implications:
- Clinicians should consider influenza B as a potential trigger for aHUS, particularly in genetically predisposed individuals.
- Awareness of this association can lead to earlier diagnosis and improved management of aHUS.
- Understanding the specific complement mutation is crucial for predicting aHUS prognosis and relapse rates.
