FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2981209969> ?p ?o ?g. }

• W2981209969 endingPage "A1212" @default.
• W2981209969 startingPage "A1212" @default.
• W2981209969 abstract "SESSION TITLE: Tuesday Fellows Case Report Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM INTRODUCTION: Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by dysfunctional complement regulation. Eculizumab, a terminal complement inhibitor, is the only drug approved for treatment of aHUS. There is a known risk of infection by encapsulated organisms with eculizumab, but there is scant data regarding infection by other organisms including invasive fungi. CASE PRESENTATION: A 57 year-old previously healthy man was admitted after months of weakness, weight loss, fever, diarrhea, blurry vision, and lower extremity numbness and cramps. Labs showed hemolytic anemia, thrombocytopenia, and acute kidney injury with proteinuria. He developed multi-organ failure requiring vasopressors. He received antibiotics and pulse-dosed steroids for treatment of microangiopathic hemolytic anemia while an etiology could be identified. However, after other etiologies were excluded, he was started on eculizumab for aHUS. Shortly after his second dose he developed fungemia with Candida Dubliniensis and acute cavernous sinusitis with biopsy-confirmed mucormycosis. Both infections progressed despite appropriate therapy and he expired on hospital day 34. Autopsy confirmed thrombotic microangiopathy consistent with aHUS. DISCUSSION: Eculizumab is a monoclonal antibody that binds the C5 complement protein and acts as a terminal complement inhibitor. It carries a well-recognized risk for infection by encapsulated organisms. Because it is a relatively new and uncommonly used drug, there may be additional infectious risks not yet reported. Aspergillus infections and a case of disseminated Cryptococcus have occurred in patients receiving eculizumab. Murine models deficient in C5 and C5a have shown susceptibility to invasive aspergillosis and Candida infection, with a high fungal load. There is pathologic evidence for complement-mediated opsonization of Mucor hyphae, and in zebrafish models, upregulation of complement proteins in Mucor-infected fish was observed. While our patient was also on steroids, corticosteroids per se are not a predominant risk factor for mucormycosis in absence of underlying immunosuppression. A case series of mucormycosis in lupus patients on steroids found that low complement was a significant additional risk factor, even more so than diabetes (75% vs 25% respectively). While it is impossible to know the relative impact that either eculizumab or steroids had in predisposing our patient to invasive fungi, there is biologic plausibility that complement inhibition likely played a role. CONCLUSIONS: Until there is more data on the full impact of terminal complement inhibition, practitioners should be highly vigilant in monitoring patients on eculizumab for infections beyond those caused by encapsulated organisms. Reference #1: Moc CC et al. Mucormycosis in systemic lupus erythematosus. Semin Arthritis Rheum. 2003 Oct;33(2):115-24. Reference #2: Lopez-Munoz A et al. An adult zebrafish model reveals that mucormycosis induces apoptosis of infected macrophages. Sci Rep. 2018 Aug 24;8(1):12802. Reference #3: Kusaba G et al. Evidence of immunopathological traces in mucormycosis: an autopsy case. Clin Exp Nephrol (2010) 14: 396. DISCLOSURES: No relevant relationships by Robert Smith, source=Web Response No relevant relationships by Maria Sunseri, source=Web Response No relevant relationships by James Tsay, source=Web Response No relevant relationships by Brandon Walsh, source=Web Response" @default.
• W2981209969 created "2019-10-25" @default.
• W2981209969 creator A5008911615 @default.
• W2981209969 creator A5011088504 @default.
• W2981209969 creator A5050556978 @default.
• W2981209969 creator A5069516728 @default.
• W2981209969 date "2019-10-01" @default.
• W2981209969 modified "2023-09-25" @default.
• W2981209969 title "MUCORMYCOSIS AND CANDIDEMIA FOLLOWING ECULIZUMAB TREATMENT FOR ATYPICAL HEMOLYTIC UREMIC SYNDROME" @default.
• W2981209969 doi "https://doi.org/10.1016/j.chest.2019.08.1098" @default.
• W2981209969 hasPublicationYear "2019" @default.
• W2981209969 type Work @default.
• W2981209969 sameAs 2981209969 @default.
• W2981209969 citedByCount "1" @default.
• W2981209969 countsByYear W29812099692019 @default.
• W2981209969 crossrefType "journal-article" @default.
• W2981209969 hasAuthorship W2981209969A5008911615 @default.
• W2981209969 hasAuthorship W2981209969A5011088504 @default.
• W2981209969 hasAuthorship W2981209969A5050556978 @default.
• W2981209969 hasAuthorship W2981209969A5069516728 @default.
• W2981209969 hasBestOaLocation W29812099691 @default.
• W2981209969 hasConcept C111684460 @default.
• W2981209969 hasConcept C126322002 @default.
• W2981209969 hasConcept C159654299 @default.
• W2981209969 hasConcept C203014093 @default.
• W2981209969 hasConcept C2776175824 @default.
• W2981209969 hasConcept C2777637130 @default.
• W2981209969 hasConcept C2777878052 @default.
• W2981209969 hasConcept C2777991916 @default.
• W2981209969 hasConcept C2778585876 @default.
• W2981209969 hasConcept C2779134260 @default.
• W2981209969 hasConcept C2781127562 @default.
• W2981209969 hasConcept C71924100 @default.
• W2981209969 hasConcept C89560881 @default.
• W2981209969 hasConcept C90924648 @default.
• W2981209969 hasConceptScore W2981209969C111684460 @default.
• W2981209969 hasConceptScore W2981209969C126322002 @default.
• W2981209969 hasConceptScore W2981209969C159654299 @default.
• W2981209969 hasConceptScore W2981209969C203014093 @default.
• W2981209969 hasConceptScore W2981209969C2776175824 @default.
• W2981209969 hasConceptScore W2981209969C2777637130 @default.
• W2981209969 hasConceptScore W2981209969C2777878052 @default.
• W2981209969 hasConceptScore W2981209969C2777991916 @default.
• W2981209969 hasConceptScore W2981209969C2778585876 @default.
• W2981209969 hasConceptScore W2981209969C2779134260 @default.
• W2981209969 hasConceptScore W2981209969C2781127562 @default.
• W2981209969 hasConceptScore W2981209969C71924100 @default.
• W2981209969 hasConceptScore W2981209969C89560881 @default.
• W2981209969 hasConceptScore W2981209969C90924648 @default.
• W2981209969 hasIssue "4" @default.
• W2981209969 hasLocation W29812099691 @default.
• W2981209969 hasOpenAccess W2981209969 @default.
• W2981209969 hasPrimaryLocation W29812099691 @default.
• W2981209969 hasRelatedWork W2598352713 @default.
• W2981209969 hasRelatedWork W2620789068 @default.
• W2981209969 hasRelatedWork W2897797027 @default.
• W2981209969 hasRelatedWork W3009707523 @default.
• W2981209969 hasRelatedWork W3039630825 @default.
• W2981209969 hasRelatedWork W3100785858 @default.
• W2981209969 hasRelatedWork W3128377634 @default.
• W2981209969 hasRelatedWork W3156388516 @default.
• W2981209969 hasRelatedWork W3198931323 @default.
• W2981209969 hasRelatedWork W4200556622 @default.
• W2981209969 hasVolume "156" @default.
• W2981209969 isParatext "false" @default.
• W2981209969 isRetracted "false" @default.
• W2981209969 magId "2981209969" @default.
• W2981209969 workType "article" @default.