ArticleMedicine2018
Eculizumab in a pregnant patient with laboratory onset of catastrophic antiphospholipid syndrome: A case report.
Article in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Treatment of Refractory/High-Risk Pregnancies With Antiphospholipid Syndrome: A Systematic Review of the Literature.Frontiers in pharmacology · 2022Pooled it
- Pediatric APS: State of the Art.Current rheumatology reports · 2020Pooled it
- IPNA clinical practice recommendations for the management of aHUS and secondary TMA in children.Pediatric nephrology (Berlin, Germany) · 2026Article
- B Cell Tolerance and Obstetric Antiphospholipid Syndrome.Clinical reviews in allergy & immunology · 2025Review
- Unresolved issues in the diagnosis and management of thrombotic antiphospholipid syndrome.Research and practice in thrombosis and haemostasis · 2025Article
- Novel advances on pathophysiological mechanisms, clinical manifestations, and treatment of antiphospholipid syndrome.Frontiers in immunology · 2025Review
- The role of complement in normal pregnancy and preeclampsia.Frontiers in immunology · 2025Review
- Myocardial Involvement in Catastrophic Antiphospholipid Syndrome during Pregnancy or Puerperium: A Case of a Young Breastfeeding Woman and Literature Review.Journal of clinical medicine · 2024Review
- Catastrophic Antiphospholipid Syndrome.International journal of molecular sciences · 2024Review
- An update on the biologics for the treatment of antiphospholipid syndrome.Frontiers in immunology · 2023Review
- Alternative pathway activation in pregnancy, a measured amount "complements" a successful pregnancy, too much results in adverse events.Immunological reviews · 2023Review
- Emerging Therapies in Antiphospholipid Syndrome.Transfusion medicine reviews · 2022Review
- Eculizumab for refractory thrombosis in antiphospholipid syndrome.Blood advances · 2022Article
- Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome: A Comprehensive Review.Journal of clinical medicine · 2022Review
- Catastrophic antiphospholipid syndrome during pregnancy.European journal of obstetrics, gynecology, and reproductive biology · 2021Review
- Antiphospholipid syndrome: Complement activation, complement gene mutations, and therapeutic implications.Journal of thrombosis and haemostasis : JTH · 2021Review
- Biologics During Pregnancy and Breastfeeding Among Women With Rheumatic Diseases: Safety Clinical Evidence on the Road.Frontiers in pharmacology · 2021Review
- Antiphospholipid syndrome.Translational research : the journal of laboratory and clinical medicine · 2020Review
- Article
- The role of beta-2-glycoprotein I in health and disease associating structure with function: More than just APS.Blood reviews · 2020Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleHypercoagulability and pregnancy morbidity are hallmarks of the antiphospholipid syndrome (APS). Catastrophic antiphospholipid syndrome (CAPS) is a potentially life-threatening omplication of APS, with widespread acute thrombotic microangiopathy (TMA) that can be precipitated by pregnancy and delivery and result in multiorgan damage. Unrestrained activation of the complement cascade is involved, favoring endothelial activation, tissue factor expression by leukocytes, and platelet aggregation. The complement block, which interrupts this amplification cycle, could prevent CAPS in patients with early TMA who face precipitating events. PATIENT CONCERNS: We present a nulliparous pregnant woman with APS at the 30 week of gestation who has developed thrombocytopenia, intravascular hemolysis, elevated creatinine, proteinuria, and hematuria. DIAGNOSES: These featurs were compatible with the diagnosis of CAPS. Consensually, serum C3 protein levels were rapidly decreasing, reflecting complement consumption.
interventionsShe was treated with eculizumab, a humanized monoclonal antibody against C5 that prevents the formation of the complement membrane attack complex. OUTCOMES: Laboratory parameters improved and the patient did not develop thrombosis or detectable organ/tissue damage. The patient safely delivered by cesarean section at week 32 of gestation a healthy 1640 g male infant. After 5 days, she received additional eculizumab, with complete resolution of the clinical condition. Low complement activity was detectable in the infant blood for a week after delivery. No infectious complication occurred. LESSONS: Inhibition of the terminal complement activation is safe and might be effective in patients with APS developing early TMA, enabling safe delivery and preventing thrombotic events both in the mother and in the newborn.
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Registered trials
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.