<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-2448</journal-id>
<journal-title><![CDATA[Acta Medica Colombiana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Med Colomb]]></abbrev-journal-title>
<issn>0120-2448</issn>
<publisher>
<publisher-name><![CDATA[Asociacion Colombiana de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-24482019000400042</article-id>
<article-id pub-id-type="doi">10.36104/amc.2019.1301</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Atypical hemolytic-uremic syndrome (aHUS)]]></article-title>
<article-title xml:lang="es"><![CDATA[Síndrome hemolítico urémico atípico (SHUa)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez-Ramírez]]></surname>
<given-names><![CDATA[Gustavo Adolfo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blanco-Pertuz]]></surname>
<given-names><![CDATA[Paola María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera-Rueda]]></surname>
<given-names><![CDATA[Guillermo Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Santa Marta  ]]></institution>
<addr-line><![CDATA[Santa Marta ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad del Magdalena  ]]></institution>
<addr-line><![CDATA[Santa Marta ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Industrial de Santander  ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>44</volume>
<numero>4</numero>
<fpage>42</fpage>
<lpage>44</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-24482019000400042&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-24482019000400042&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-24482019000400042&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Atypical hemolytic-uremic syndrome (aHUS) is a diagnosis of exclusion which should be proposed in cases where there is microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury. It is associated with mutations which cause dysregulation of the complement system and implies an adverse prognosis and a high risk of progression to chronic kidney disease. Following, we present the case of a patient with aHUS, highlighting the effect and importance of biologic therapy with the monoclonal antibody eculizumab. (Acta Med Colomb 2019; 44. DOI:https://doi.org/10.36104/amc.2019.1301).]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El síndrome hemolítico urémico atípico (SHUa) constituye un diagnóstico de exclusión que debe plantearse ante la presencia de anemia hemolítica microangiopática, trombocitopenia y lesión renal aguda. Está asociado con mutaciones que provocan una disregulación del sistema del complemento e implica un pronóstico adverso y alto riesgo de progresión a enfermedad renal crónica. A continuación, presentamos el caso de un paciente con SHUa resaltando el efecto e importancia de la terapia biológica con el anticuerpo monoclonal eculizumab. (Acta Med Colomb 2019; 44. DOI:https://doi.org/10.36104/amc.2019.1301).]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[atypical hemolytic-uremic syndrome]]></kwd>
<kwd lng="en"><![CDATA[complement activation]]></kwd>
<kwd lng="en"><![CDATA[thrombotic microangiopathies]]></kwd>
<kwd lng="en"><![CDATA[chronic renal failure]]></kwd>
<kwd lng="en"><![CDATA[monoclonal antibodies]]></kwd>
<kwd lng="es"><![CDATA[síndrome hemolítico urémico atípico]]></kwd>
<kwd lng="es"><![CDATA[activación de complemento]]></kwd>
<kwd lng="es"><![CDATA[microangiopatías trombóticas]]></kwd>
<kwd lng="es"><![CDATA[fallo renal crónico]]></kwd>
<kwd lng="es"><![CDATA[anticuerpos monoclonales]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yoshida]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Kato]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Nangaku]]></surname>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical hemolytic uremic syndrome]]></article-title>
<source><![CDATA[Renal Replacement Therapy]]></source>
<year>2017</year>
<numero>3</numero>
<issue>3</issue>
<page-range>5</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sullivan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Erlic]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Hoffmann]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Arbeiter]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Patzer]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Budde]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiological approach to identifying genetic predispositions for atypical hemolytic uremic syndrome]]></article-title>
<source><![CDATA[Ann Hum Genet]]></source>
<year>2010</year>
<volume>74</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>17-26</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kavanagh]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Goodship]]></surname>
<given-names><![CDATA[TH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical hemolytic uremic syndrome]]></article-title>
<source><![CDATA[In Seminars in nephrology]]></source>
<year>2013</year>
<volume>33</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>508-30</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roldán-Tabares]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[C Atypical hemolytic uremic syndrome: role of the genetic profile]]></article-title>
<source><![CDATA[Medicina Interna de México]]></source>
<year>2018</year>
<volume>34</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>394-402</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaplan]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
<name>
<surname><![CDATA[Ruebner]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Spinale]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Copelovitch]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current treatment of atypical hemolytic uremic syndrome]]></article-title>
<source><![CDATA[Intractable &amp; rare diseases research.]]></source>
<year>2014</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>34-45</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campistol]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Arias]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ariceta]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Blasco]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Espinosa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Grinyó]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez de Córdoba]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Actualización en síndrome hemolítico urémico atípico: diagnóstico y tratamiento: Documento de consenso]]></article-title>
<source><![CDATA[Nefrología]]></source>
<year>2013</year>
<volume>33</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>27-45</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zuckerman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Asif]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Costanzo]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Vachharajani]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complement activation in atypical hemolytic uremic syndrome and scleroderma renal crisis: a critical analysis of pathophysiology]]></article-title>
<source><![CDATA[Brazilian Journal of Nephrology]]></source>
<year>2018</year>
<volume>40</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>77-81</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sridharan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Go]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Willrich]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical hemolytic uremic syndrome: Review of clinical presentation, diagnosis and management]]></article-title>
<source><![CDATA[Journal of immunological methods]]></source>
<year>2018</year>
<numero>461</numero>
<issue>461</issue>
<page-range>15-22</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kato H]]></surname>
<given-names><![CDATA[Nangaku M]]></given-names>
</name>
<name>
<surname><![CDATA[Kato]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Hataya H]]></surname>
<given-names><![CDATA[Sawai T]]></given-names>
</name>
<name>
<surname><![CDATA[Ashida A]]></surname>
<given-names><![CDATA[Kagami]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical guides for atypical hemolytic uremic syndrome in Japan]]></article-title>
<source><![CDATA[Clinical and Experimental Nephrology]]></source>
<year>2016</year>
<volume>20</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>536-43</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Córdoba]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Contreras]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Larrarte]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Espitaleta]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Ibarra]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Prada]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Síndrome hemolítico urémico atípico, revisión de la literatura y documento de consenso. Enfoque diagnóstico y tratamiento]]></article-title>
<source><![CDATA[Revista Colombiana de Nefrología]]></source>
<year>2015</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>19-40</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coppo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Schwarzinger]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Buffet]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wynckel]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Clabault]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Presne]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictive features of severe acquired ADAMTS13 deficiency in idiopathic thrombotic microangiopathies: the French TMA reference center experience]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year>2010</year>
<volume>23</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gulleroglu]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Fidan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Hançer]]></surname>
<given-names><![CDATA[VS]]></given-names>
</name>
<name>
<surname><![CDATA[Bayrakci]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Baskin]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Soylemezoglu]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurologic involvement in atypical hemolytic uremic syndrome and successful treatment with eculizumab]]></article-title>
<source><![CDATA[Pediatric Nephrology]]></source>
<year>2013</year>
<volume>28</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>827-30</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Legendre C]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Licht]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Muus]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Greenbaum]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Babu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bedrosian]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Eitner]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Terminal complement inhibitor eculizumab in atypical hemolytic-ure-mic syndrome]]></article-title>
<source><![CDATA[New England Journal of Medicine]]></source>
<year>2013</year>
<volume>368</volume>
<numero>23</numero>
<issue>23</issue>
<page-range>2169-81</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Licht]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Greenbaum]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Muus]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Efficacy and safety of eculizimab in atypical hemolytic uremic syndrome from 2-year extension of phase 2 studies]]></article-title>
<source><![CDATA[Kidney Int]]></source>
<year>2015</year>
<numero>87</numero>
<issue>87</issue>
<page-range>1061-73</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berger]]></surname>
<given-names><![CDATA[BE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical hemolytic uremic syndrome: a syndrome in need of clarity]]></article-title>
<source><![CDATA[Clinical Kidney Journal.]]></source>
<year>2018</year>
<volume>3</volume>
<page-range>338-47</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sethi]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Rohatgi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Dragon-Durey]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Raghunathan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Dhaliwal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rawat]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kher]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Eculizumab for atypical hemolytic-uremic syndrome in India: First report from India and the challenges faced]]></article-title>
<source><![CDATA[Indian journal of nephrology]]></source>
<year>2017</year>
<volume>27</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>58-61</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McNamara]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Topaz]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Hariri]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fox]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[MacNeil]]></surname>
<given-names><![CDATA[JR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High risk for invasive meningococcal disease among patients receiving eculizumab (Soliris) despite receipt of meningococcal vaccine. MMWR]]></article-title>
<source><![CDATA[Morbidity and mortality weekly report]]></source>
<year>2017</year>
<volume>66</volume>
<numero>27</numero>
<issue>27</issue>
<page-range>734</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
