{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T19:46:11Z","timestamp":1778183171598,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T00:00:00Z","timestamp":1564531200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T00:00:00Z","timestamp":1564531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Atypical hemolytic uremic syndrome (aHUS) is an ultra-rare disease induced by many triggers, all of which produce a common end phenotype of microangiopathic hemolysis and thrombotic microangiopathy. We herein describe a 63-year-old woman with ongoing protein-losing enteropathy and frequent transudates caused by hypoalbuminemia. The patient was treated with eculizumab with a full hematologic and partial renal response. Protein-losing enteropathy is an inflammatory condition that has been linked with increased complement activation, which can trigger aHUS in patients with loss of CD55 expression. The patient in the present case had an increased estimated glomerular filtration rate but stage IV to V chronic kidney disease. One year later, she remains off dialysis with a stable estimated glomerular filtration rate. We herein report an unusual trigger of complement activation that in turn triggered aHUS in this patient.<\/jats:p>","DOI":"10.1177\/0300060519864808","type":"journal-article","created":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T05:45:36Z","timestamp":1564551936000},"page":"4027-4032","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Atypical hemolytic uremic syndrome in a patient with protein-losing enteropathy"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1807-8909","authenticated-orcid":false,"given":"Ramy M.","family":"Hanna","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huma","family":"Hasnain","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lama","family":"Abdelnour","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beshoy","family":"Yanny","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Digestive Diseases, Hepatology UCLA David Geffen School of Medicine, Los Angeles, CA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M.","family":"Burwick","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, CA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.5301\/jo-n.5000021"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1312353"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615887"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.2.628"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010208"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208981"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-016-0288-3"},{"key":"e_1_3_3_9_2","first-page":"310","article-title":"Current evidence on the discontinuation of eculizumab in patients with atypical hemolytic-uremic syndrome","volume":"10","author":"Macia M","year":"2017","unstructured":"Macia M, de Alvaro Moreno F, Dutt T, et\u00a0al. Current evidence on the discontinuation of eculizumab in patients with atypical hemolytic-uremic syndrome. Clin Kidney J 2017; 10: 310\u2013319.","journal-title":"Clin Kidney J"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1159\/000492033"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00337"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.01.434"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcv082"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-02-770214"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06440616"},{"key":"e_1_3_3_16_2","volume-title":"GeneReviews\u00ae [Internet]","author":"Noris M","year":"1993","unstructured":"Noris M, Bresin E, Mele C, et\u00a0al. Genetic atypical hemolytic-uremic syndrome. In: Adam MP, Ardinger HH, Pagon RA, et\u00a0al. (eds). GeneReviews\u00ae [Internet]. Seattle (WA): University of Washington, Seattle, 1993-2019. 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