Administration of Eculizumab, a C5 Inhibitor, for the Treatment of Shiga-Toxin-Producing Escherichia coli Infection: A Case Report

Hemolytic-uremic syndrome (HUS), which is characterized by microvascular hemolytic anemia, consumption thrombocytopenia, and acute renal failure, is a complication of the Shiga-toxin-producing Escherichia coli (STEC) infection. We describe the case of a patient who, despite undergoing plasma exchange and renal replacement therapy for STEC-induced HUS, experienced poor improvement in platelet count, serum creatinine level, and serum lactate dehydrogenase level. The patient developed acute encephalopathy but recovered without permanent organ damage after eculizumab therapy. For severe HUS cases involving the central nervous system, early administration of eculizumab, which inhibits the abnormal activation of the complement activation pathway, may be effective.