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Syndromes of Thrombotic Microangiopathy
Journal article   Open access   Peer reviewed

Syndromes of Thrombotic Microangiopathy

Shraga Aviner, Haim Bibi, Fabio Villa, Martin Kömhoff, Marcus T Roofthooft, Francjan Spronsen, James N George and Carla M Nester
The New England journal of medicine, Vol.371(19), pp.1846-1848
11/06/2014
DOI: 10.1056/NEJMc1410951
PMID: 25372103
url
https://doi.org/10.1056/NEJMc1410951View
Published (Version of record) Open Access

Abstract

To the Editor: In their review of the thrombotic microangiopathy syndromes, George and Nester (Aug. 14 issue) 1 do not mention the option of treating severe neurologic deficits in patients with shiga toxin–mediated hemolytic–uremic syndrome (ST-HUS) with IgG depletion through immunoadsorption. 2 In the 2011 outbreak in northern Germany, the delay in the onset of neurologic symptoms (5 to 12 days after the onset of diarrhea; mean and median, 8.0 days) strongly suggested antibody involvement in the pathogenesis of these symptoms. Consequently, all 12 patients had substantial improvement, and 10 of them fully recovered after IgG depletion through immunoadsorption, despite the failure . . .

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