ReviewPediatric nephrology (Berlin, Germany)2018
Influenza-associated thrombotic microangiopathies.
Review in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- COMDORA-SBN recommendations for patients with rare kidney diseases in relation to the Covid-19 pandemic.Jornal brasileiro de nefrologia · 2020Guideline
- IPNA clinical practice recommendations for the management of aHUS and secondary TMA in children.Pediatric nephrology (Berlin, Germany) · 2026Article
- Influenza A(H1N1) triggered atypical hemolytic uremic syndrome in a child with homozygous CD46 variant successfully treated with ravulizumab: a case report.CEN case reports · 2026Article
- Causes and outcomes of pediatric thrombotic microangiopathy.Research and practice in thrombosis and haemostasis · 2026Article
- Article
- Case Report: CAR-T cell therapy bridging to allogeneic hematopoietic stem cell transplantation triggers Purtscher-like retinopathy: clinical features and complement-mediated microvascular injury mechanisms.Frontiers in immunology · 2026Article
- A Case Report of Atypical Hemolytic Uremic Syndrome Presenting With Disseminated Intravascular Coagulation.Cureus · 2025Article
- Influenza A H1N1 Triggering Complement-Mediated Hemolytic Uremic Syndrome.Journal of medical cases · 2025Article
- Safety evaluation of baloxavir marboxil: analysis and discussion utilizing real adverse events from the FAERS database.BMC pharmacology & toxicology · 2025Article
- Life-Threatening Anemia and Thrombocytopenia in a Toddler with Influenza B: Case Report and Literature Review.Children (Basel, Switzerland) · 2025Article
- Post-transplant Thrombotic Microangiopathy.Journal of the American Society of Nephrology : JASN · 2025Review
- Transient Haemolytic Anaemia and Thrombocytopenia in a Healthy Young Adult Following Influenza a Infection.European journal of case reports in internal medicine · 2025Article
- Atypical presentation of H1N1-induced thrombotic microangiopathy with CD46 gene mutation .Clinical nephrology. Case studies · 2025Article
- A pediatric case of atypical hemolytic uremic syndrome (aHUS): Could any infection play a triggering role?Clinical nephrology. Case studies · 2024Article
- Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report.HCA healthcare journal of medicine · 2024Article
- The Role of the Complement System in the Pathogenesis of Infectious Forms of Hemolytic Uremic Syndrome.Biomolecules · 2023Review
- COVID-19 and Glomerular Diseases.Kidney international reports · 2023Review
- Is Endothelial Activation a Critical Event in Thrombotic Thrombocytopenic Purpura?Journal of clinical medicine · 2023Review
- Comparison of the incidence of bleeding between baloxavir marboxil and other anti-influenza drugs among outpatients with influenza virus infection: A retrospective cohort study using an employment-based health insurance claims database in Japan.Pharmacoepidemiology and drug safety · 2022Article
- Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Thrombotic microangiopathy (TMA) refers to phenotypically similar disorders, including hemolytic uremic syndromes (HUS) and thrombotic thrombocytopenic purpura (TTP). This review explores the role of the influenza virus as trigger of HUS or TTP. We conducted a literature survey in PubMed and Google Scholar using HUS, TTP, TMA, and influenza as keywords, and extracted and analyzed reported epidemiological and clinical data. We identified 25 cases of influenza-associated TMA. Five additional cases were linked to influenza vaccination and analyzed separately. Influenza A was found in 83%, 10 out of 25 during the 2009 A(H1N1) pandemic. Two patients had bona fide TTP with ADAMTS13 activity <10%. Median age was 15 years (range 0.5-68 years), two thirds were male. Oligoanuria was documented in 81% and neurological involvement in 40% of patients. Serum C3 was reduced in 5 out of 14 patients (36%); Coombs test was negative in 7 out of 7 and elevated fibrin/fibrinogen degradation products were documented in 6 out of 8 patients. Pathogenic complement gene mutations were found in 7 out of 8 patients tested (C3, MCP, or MCP combined with CFB or clusterin). Twenty out of 24 patients recovered completely, but 3 died (12%). Ten of the surviving patients underwent plasma exchange (PLEX) therapy, 5 plasma infusions. Influenza-mediated HUS or TTP is rare. A sizable proportion of tested patients demonstrated mutations associated with alternative pathway of complement dysregulation that was uncovered by this infection. Further research is warranted targeting the roles of viral neuraminidase, enhanced virus-induced complement activation and/or ADAMTS13 antibodies, and rational treatment approaches.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.