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Salhi S, Ribes D, Faguer S. Complement C5 inhibition reverses bleomycin-induced thrombotic microangiopathy. Clin Kidney J. 2020;14(4):1275-1276doi: 10.1093/ckj/sfaa101.
Salhi, S., Ribes, D., & Faguer, S. (2021). Complement C5 inhibition reverses bleomycin-induced thrombotic microangiopathy. Clinical kidney journal, 14(4), 1275-1276. https://doi.org/10.1093/ckj/sfaa101
Salhi, Sofiane, et al. "Complement C5 inhibition reverses bleomycin-induced thrombotic microangiopathy." Clinical kidney journal vol. 14,4 (2021): 1275-1276. doi: https://doi.org/10.1093/ckj/sfaa101
Salhi S, Ribes D, Faguer S. Complement C5 inhibition reverses bleomycin-induced thrombotic microangiopathy. Clin Kidney J. 2020 Jul 09;14(4):1275-1276. doi: 10.1093/ckj/sfaa101. eCollection 2021 Apr. PMID: 33841872; PMCID: PMC8023184.
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Clin Kidney J. 2020 Jul 09;14(4):1275-1276. doi: 10.1093/ckj/sfaa101. eCollection 2021 Apr.

Complement C5 inhibition reverses bleomycin-induced thrombotic microangiopathy.

Clinical kidney journal

Sofiane Salhi, David Ribes, Stanislas Faguer

Affiliations

  1. Department of Nephrology and Organ Transplantation, Centre for Rare Renal Diseases, University Hospital of Toulouse, Toulouse, France.
  2. Institut National de la Santé et de la Recherche Médicale, U1048-Institut des Maladies Métaboliques et Cardiovasculaires, French Intensive care Renal Network, Toulouse, France.
  3. Université Paul Sabatier, Toulouse 3, Toulouse, France.

PMID: 33841872 PMCID: PMC8023184 DOI: 10.1093/ckj/sfaa101

Abstract

Whether C5 blocking may improve the outcomes of patients developing chemotherapy-induced thrombotic microangiopathy (TMA) remains elusive. Lung fibrosis is a well-known complication of bleomycin, whereas TMAs are very rare (<20 cases described). Here, we report an exceptional case of a male patient that developed acute respiratory distress syndrome and TMA following administration of bleomycin, cisplatin and etoposide . Refractoriness to plasma exchanges prompted us to use eculizumab as salvage therapy. Eculizumab led to complete remission of the TMA before Day 2. However, the patient progressed towards refractory respiratory failure, suggesting that pathophysiological mechanisms of bleomycin-induced lung fibrosis and TMA differ.

© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.

Keywords: bleomycin; complement; eculizumab; lung fibrosis; thrombotic microangiopathy

References

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  5. Ann Intern Med. 1986 Jul;105(1):48-51 - PubMed

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