Recurrent Atypical Hemolytic Uremic Syndrome Associated With Factor I Mutation in a Living Related Renal Transplant Recipient

Micah R. Chan, Christie P. Thomas, Jose R. Torrealba, Arjang Djamali, Luis A. Fernandez, Carla J. Nishimura, Richard J H Smith, Millie D. Samaniego

Research output: Contribution to journalArticle

25 Scopus citations


Atypical hemolytic uremic syndrome, or the nondiarrheal form of hemolytic uremic syndrome, is a rare disorder typically classified as familial or sporadic. Recent literature has suggested that approximately 50% of patients have mutations in factor H (CFH), factor I (CFI), or membrane cofactor protein (encoded by CD46). Importantly, results of renal transplantation in patients with mutations in either CFH or CFI are dismal, with recurrent disease leading to graft loss in the majority of cases. We describe an adult renal transplant recipient who developed recurrent hemolytic uremic syndrome 1 month after transplantation. Bidirectional sequencing of CFH, CFI, and CD46 confirmed that the patient was heterozygous for a novel missense mutation, a substitution of a serine reside for a tyrosine residue at amino acid 369, in CFI. This report reemphasizes the importance of screening patients with atypical hemolytic uremic syndrome for mutations in these genes before renal transplantation and shows the challenges in the management of these patients.

Original languageEnglish (US)
Pages (from-to)321-326
Number of pages6
JournalAmerican Journal of Kidney Diseases
Issue number2
StatePublished - Feb 1 2009



  • Kidney transplant
  • factor I
  • hemolytic uremic syndrome (HUS)
  • recurrent

ASJC Scopus subject areas

  • Nephrology

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