Hemolytic-uremic syndrome future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Sogand Goudarzi, MD [2] Parth Vikram Singh, MBBS[3]
Overview
Several disease-modifying treatments have been proposed for STEC-associated HUS, but effective targeted therapy remains unproven. Because Shiga toxin 2 has been identified in serum and in or on circulating blood cells and microvesicles shortly before or during HUS, extraintestinal Shiga toxin remains a potential therapeutic target. Until effective therapies are validated, management should focus on rapid diagnosis, close monitoring, avoidance of harmful interventions, prevention of volume depletion, and correction of modifiable risk factors.[1]
Future or Investigational Therapies
- ASA and dipyridamole not effective alone,benefit when added to plasma exchange
- In poorly responsive or resistant disease, INCREASE PLASMA EXCHANGE
- Then consider:
- prednisone (1 mg/kg per day)
- methylprednisolone (125 mg IV bid)
- Vincristine
- IVIG