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Steroid Responsive Atypical Hemolytic Uremic Syndrome Triggered by Influenza B Infection

Mittal, Nupur, MD*; Hartemayer, Robert, MD*; Jandeska, Sara, MD; Giordano, Lisa, MD*

Journal of Pediatric Hematology/Oncology: January 2019 - Volume 41 - Issue 1 - p e63–e67
doi: 10.1097/MPH.0000000000001180
Online Articles: Clinical and Laboratory Observations

Atypical hemolytic uremic syndrome (aHUS) is characterized by uncontrolled complement activation leading to thrombotic microangiopathy and severe end-organ damage. The most common trigger for an episode of aHUS in the background of genetic deregulation of the alternative complement pathway is systemic infection. There are only 4 reported cases of aHUS triggered by influenza B thus far. Current accepted therapies for aHUS include plasma exchange and eculizumab. We describe a unique patient with aHUS with a rare membrane cofactor protein mutation triggered by influenza B infection, who achieved complete remission with treatment with high-dose corticosteroids after failure of plasmapheresis.

*Department of Pediatrics, Division of Pediatric Hematology Oncology

Department of Pediatrics, Division of Pediatric Nephrology, Rush University Children’s Hospital , Chicago, IL

The authors declare that they have nothing to disclose.

Reprints: Nupur Mittal, MD, Rush University Children’s Hospital, 1725 West Harrison St, Suite 710, Chicago, IL 60612 (e-mail:

Received September 8, 2017

Accepted February 28, 2018

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.