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Case Reports in Nephrology
Volume 2018, Article ID 1727986, 4 pages
https://doi.org/10.1155/2018/1727986
Case Report

De Novo Atypical Haemolytic Uremic Syndrome after Kidney Transplantation

1Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
2Division of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
3Division of Pathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
4Division of Human Genetics, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
5Center of Human Genetics, Institut de Pathologie et de Génétique, Gosselies, Belgium

Correspondence should be addressed to Nada Kanaan; eb.niavuolcu@naanak.adan

Received 15 November 2017; Revised 23 January 2018; Accepted 14 February 2018; Published 14 March 2018

Academic Editor: Sophia Lionaki

Copyright © 2018 Arnaud Devresse et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

De novo thrombotic microangiopathy (TMA) can occur after kidney transplantation. An abnormality of the alternative pathway of complement must be suspected and searched for, even in presence of a secondary cause. We report the case of a 23-year-old female patient who was transplanted with a kidney from her mother for end-stage renal disease secondary to Hinman syndrome. Early after transplantation, she presented with 2 episodes of severe pyelonephritis, associated with acute kidney dysfunction and biological and histological features of TMA. Investigations of the alternative pathway of the complement system revealed atypical haemolytic uremic syndrome secondary to complement factor I mutation, associated with mutations in CD46 and complement factor H related protein genes. Plasma exchanges followed by eculizumab injections allowed improvement of kidney function without, however, normalization of creatinine.