ArticlePediatric nephrology (Berlin, Germany)2015
Effect of plasma exchange and immunosuppressive medications on antibody titers and outcome in anti-complement factor H antibody-associated hemolytic uremic syndrome.
Article in Pediatric nephrology (Berlin, Germany), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 42 citations in OpenAlex.
- IPNA clinical practice recommendations for the management of aHUS and secondary TMA in children.Pediatric nephrology (Berlin, Germany) · 2026Article
- Indications and recent evidence for apheresis in children and adults with kidney diseases: a comprehensive review.Clinical kidney journal · 2025Review
- Complement-mediated HUS revisited: evolving insights into pathophysiology, diagnosis, and treatment.Frontiers in immunology · 2025Review
- Anti-CFH-associated hemolytic uremic syndrome: do we still need plasma exchange?Pediatric nephrology (Berlin, Germany) · 2024Article
- Abbreviated protocol of plasma exchanges for patients with anti-factor H associated hemolytic uremic syndrome.Pediatric nephrology (Berlin, Germany) · 2024Article
- Clinical features of children with anti-CFH autoantibody-associated hemolytic uremic syndrome: a report of 8 cases.Renal failure · 2022Article
- Role of therapeutic apheresis in the treatment of pediatric kidney diseases.Pediatric nephrology (Berlin, Germany) · 2022Article
- Anti-factor H antibody and its role in atypical hemolytic uremic syndrome.Frontiers in immunology · 2022Article
- Deficiency of CFHR plasma proteins and autoantibody positive hemolytic uremic syndrome: treatment rationale, outcomes, and monitoring.Pediatric nephrology (Berlin, Germany) · 2021Review
- Anti-Factor H Antibodies in Egyptian Children with Hemolytic Uremic Syndrome.International journal of nephrology · 2021Article
- Efficacy and safety of rituximab in autoimmune and microangiopathic hemolytic anemia: a systematic review and meta-analysis.Experimental hematology & oncology · 2020Article
- Hemolytic uremic syndrome in a developing country: Consensus guidelines.Pediatric nephrology (Berlin, Germany) · 2019Article
- Clinical and Immunological Profile of Anti-factor H Antibody Associated Atypical Hemolytic Uremic Syndrome: A Nationwide Database.Frontiers in immunology · 2019Article
- Deficiency of complement factor H-related proteins and autoantibody-positive hemolytic uremic syndrome in an infant with combined partial deficiencies and autoantibodies to complement factor H and ADAMTS13.Clinical kidney journal · 2018Article
- Complement-mediated renal diseases after kidney transplantation - current diagnostic and therapeutic options inWorld journal of transplantation · 2018Review
- Thrombotic microangiopathy after renal transplantation: Current insights inWorld journal of transplantation · 2018Review
- Factor H autoantibody is associated with atypical hemolytic uremic syndrome in children in the United Kingdom and Ireland.Kidney international · 2017Article
- Successful discontinuation of eculizumab under immunosuppressive therapy in DEAP-HUS.Pediatric nephrology (Berlin, Germany) · 2017Review
- The clinical and laboratory features of Chinese Han anti-factor H autoantibody-associated hemolytic uremic syndrome.Pediatric nephrology (Berlin, Germany) · 2017Article
- Anti-complement-factor H-associated glomerulopathies.Nature reviews. Nephrology · 2016Review
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnti-complement factor H (anti-CFH) antibody-associated hemolytic uremic syndrome (HUS) is an important cause of acute kidney injury in Indian children. While management comprises plasma exchange and immunosuppression, information on the impact on serial antibody titers and outcomes is limited.
methodsThis retrospective study included 45 patients with anti-CFH-associated HUS who were followed for ≥12 months. Following the initial plasma exchange sessions, patients received prednisolone and either intravenous (IV) cyclophosphamide (n = 31) or IV rituximab (n = 14), followed by maintenance immunosuppression.
resultsThe median anti-CFH antibody titers fell from 3,215.5 [interquartile range (IQR) 1,977.9-8,453.9 to 414.6 (IQR 251.6-1,368.2) AU/ml with plasma exchange therapy (P < 0.0001), and the decline was similar with three, five, or seven plasma exchange sessions (P = 0.08). Serial anti-CFH titers were similar in patients receiving IV cyclophosphamide- and rituximab-based regimens during the 12-month follow-up (P = 0.63). Renal outcomes and relapse frequencies at the 15.4-month follow-up were comparable. Seven patients relapsed 6.5 (IQR 2.2-12.3) months from treatment onset. Patients with relapse had higher antibody titers during remission (P = 0.017). Titers of ≥1,300 AU/ml at 6 months predicted subsequent relapses.
conclusionsOur patients with anti-CFH antibody-associated HUS showed a significant fall in antibody titers following daily plasma exchange sessions. Therapy with cyclophosphamide- or rituximab-based regimens was associated with similar outcomes and a comparable decline in antibody titers.
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