{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:17:24Z","timestamp":1780391844883,"version":"3.54.1"},"reference-count":8,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nephron"],"published-print":{"date-parts":[[2022]]},"abstract":"Hemolytic uremic syndrome (HUS) is a rare disease characterized by hemolytic anemia, thrombocytopenia, and renal impairment mostly triggered by strains of Shiga-like toxin-producing <i>Escherichia coli<\/i> (STEC-HUS). A rarer form of HUS, defined as atypical HUS (aHUS), is associated with genetic or acquired dysregulation of the alternative pathway of the complement system and presents a poorer prognosis than STEC-HUS. Factor H autoantibodies (anti-FHs) have been reported in aHUS in 5\u201311% of cases and are strongly associated with the homozygous deletion of <i>CFHR3-CFHR1<\/i> genes. In the large majority of patients, anti-FH-associated aHUS is commonly preceded by gastrointestinal or respiratory tract infections. Here, we described the clinical case of a 3-year-old boy who was hospitalized for aHUS preceded by <i>Mycoplasma pneumoniae<\/i> (MP) infection. He resulted positive for anti-FHs and carried the homozygous deletion of <i>CFHR3-CFHR1<\/i>. Of relevance, he also showed a variant of unknown significance in the <i>C5<\/i> gene. The patient was successfully treated with eculizumab and achieved hematological and renal remission. The anti-FH titer decreased, became negative after 6 months of mycophenolate mofetil (MMF) treatment, and remained negative for 21-month follow-up indicating that immunosuppression was effective and could prevent the reappearance of anti-FHs. We hypothesized that MP, likely through an evasion strategy of immunosurveillance based on binding of pathogen to FH, triggers anti-FH antibody generation and aHUS in a subject genetically predisposed. In conclusion, to the best of our knowledge, here, we reported the first case of anti-FH-mediated aHUS after an MP infection who benefited from eculizumab and immunosuppressive therapy based on MMF. Hence, monitoring of anti-FHs in patients with post-MP infection glomerulonephritis could be recommended, especially in those with low C3 plasma levels. <\/jats:p>","DOI":"10.1159\/000523998","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T21:00:48Z","timestamp":1649710848000},"page":"593-598","source":"Crossref","is-referenced-by-count":4,"title":["<b><i>Mycoplasma pneumoniae<\/i><\/b> Infection Associated with Anti-Factor H Autoantibodies in Atypical Hemolytic Uremic Syndrome"],"prefix":"10.1159","volume":"146","author":[{"given":"Elisabetta","family":"Valoti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Piras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Mele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Alberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7784-1172","authenticated-orcid":false,"given":"Lucia","family":"Liguori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Breno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Bertulli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bresin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Donadelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr3421w"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gky1016"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-010-0044-x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.47.1.15-20.1985"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.17.4.697-728.2004"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-013-0407-3"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.602277"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-013-2541-5"}],"container-title":["Nephron"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/523998","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/523998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:56:49Z","timestamp":1745423809000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000523998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":8,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,12,7]]},"published-print":{"date-parts":[[2022,12,13]]}},"URL":"https:\/\/doi.org\/10.1159\/000523998","archive":["Portico"],"relation":{},"ISSN":["1660-8151","2235-3186"],"issn-type":[{"value":"1660-8151","type":"print"},{"value":"2235-3186","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]}}}