{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:45:53Z","timestamp":1781732753047,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T00:00:00Z","timestamp":1690070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A limited number of cases of thrombotic microangiopathy (TMA) have previously been reported in association with COVID\u201019. Our report describes two cases of TMA associated with COVID\u201019, one of which was successfully treated with eculizumab. The first case was a 23\u2010month\u2010old girl, and the second case was a 9\u2010month\u2010old boy. PCR tests for SARS\u2010CoV\u20102 were positive in both cases, and laboratory results showed microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. No known aetiology for TMA was found in either case. Stool tests for Shigatoxin\u2010producing Escherichia coli were negative. Coagulation tests, ADAMTS13 activity, serum complement levels, and homocysteine levels were all within the normal range. No known genetic mutation was found, including mutations of complement, diacylglycerol kinase epsilon, and cobalamin C. In the first case, eculizumab was administered due to persistent haemolysis and prolonged anuria. In conclusion, TMA may be associated with COVID\u201019 infection. Treatment with eculizumab may be beneficial in selected patients because of the potential activation of the complement system.<\/jats:p>","DOI":"10.1111\/nep.14225","type":"journal-article","created":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T23:48:22Z","timestamp":1690156102000},"page":"557-560","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["<scp>COVID<\/scp>\u201019 associated thrombotic microangiopathy"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6097-657X","authenticated-orcid":false,"given":"Esra","family":"Karabag Yilmaz","sequence":"first","affiliation":[{"name":"Department of Paediatric Nephrology Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1327-0638","authenticated-orcid":false,"given":"Memnune Nur","family":"Cebi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iremnaz","family":"Karahan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2424-6959","authenticated-orcid":false,"given":"Seha","family":"Sayg\u0131l\u0131","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nephrology Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5504-3516","authenticated-orcid":false,"given":"Ruveyda","family":"Gulmez","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nephrology Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9348-2376","authenticated-orcid":false,"given":"Ebru Burcu","family":"Demirgan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nephrology Istanbul Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6309-8859","authenticated-orcid":false,"given":"Cansu","family":"Durak","sequence":"additional","affiliation":[{"name":"Department of Paediatric Intensive Care Unit Sancaktepe Sehit Prof. Dr. \u0130lhan Varank Training and Research Hosp\u0131tal  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6519-6583","authenticated-orcid":false,"given":"Fatih","family":"Aygun","sequence":"additional","affiliation":[{"name":"Department of Paediatric Intensive Care Unit Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-0164","authenticated-orcid":false,"given":"Fatih","family":"Ozaltin","sequence":"additional","affiliation":[{"name":"Nephrogenetics Laboratory, Department of Pediatrics Hacettepe University School of Medicine  Ankara Turkey"},{"name":"Department of Paediatric Nephrology, Faculty of Medicine Hacettepe University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3316-8032","authenticated-orcid":false,"given":"Salim","family":"Caliskan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nephrology Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-9756","authenticated-orcid":false,"given":"Nur","family":"Canpolat","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nephrology Istanbul University\u2010Cerrahpasa, Cerrahpasa Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5394"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14869"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2008597"},{"key":"e_1_2_6_7_1","first-page":"1","article-title":"Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID\u201019 infection: a report of five cases","volume":"20","author":"Magro C","year":"2020","journal-title":"TranslRes"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16783"},{"issue":"23","key":"e_1_2_6_9_1","first-page":"6051","article-title":"Evidence of thrombotic microangiopathy in children with SARS\u2010CoV\u20102 across the spectrum of clinical presentations","volume":"4","author":"Diorio C","year":"2020","journal-title":"BloodAdv"},{"key":"e_1_2_6_10_1","first-page":"1","article-title":"Pathology findings in pediatric patients with COVID\u201019 and kidney dysfunction","volume":"15","author":"Nomura E","year":"2022","journal-title":"Pediatr Nephrol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-016774"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-020-00858-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/11795565211049897"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.659069"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.11830720"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14134"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.05.006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.594849"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.156"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw453"},{"key":"e_1_2_6_21_1","first-page":"4040","article-title":"Eculizumab treatment in patients with COVID\u201019: preliminary results from real life ASL Napoli 2 Nordexperience","volume":"24","author":"Diurno F","year":"2020","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2020.108555"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms231911307"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:05:08Z","timestamp":1693785908000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.14225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,23]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/nep.14225"],"URL":"https:\/\/doi.org\/10.1111\/nep.14225","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,23]]},"assertion":[{"value":"2022-11-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}