Hemolytic Uremic Syndrome in Emergency Medicine Medication

Updated: Dec 27, 2017
  • Author: Audrey J Tan, DO; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Medication Summary

Management consists of early dialysis for acute renal failure and general supportive care, including treatment of hypertension. Eculizumab is the first treatment approved by the US Food and Drug Administration (FDA) in September 2011 for adults and children with atypical hemolytic uremic syndrome (aHUS).

Refractory cases have been treated with vincristine or cyclosporine A. Steroids are of questionable benefit, as are antiplatelet agents such as aspirin or dipyridamole. Fibrinolytic therapy is not only ineffective but it also increases the risk of bleeding. Platelet transfusions can worsen the patient's status by inducing further organ damage.


Monoclonal Antibodies, Endocrine

Class Summary

Eculizumab is a monoclonal antibody indicated for atypical hemolytic uremic syndrome to inhibit complement-mediated thrombotic microangiopathy; effectiveness is based on the effects on thrombotic microangiopathy and renal function. It is not indicated for patients with Shiga toxin Escherichia coli – related hemolytic uremic syndrome (STEC-HUS).

Eculizumab (Soliris)

Monoclonal blocking antibody to complement protein C5; inhibits cleavage to C5a and C5b, thus preventing terminal complement complex C5b-9, thereby preventing RBC hemolysis. Inhibits terminal complement mediated intravascular hemolysis in PNH patients and complement-mediated thrombotic microangiopathy (TMA) in patients with aHUS.