Disseminated Cryptococcosis Following Eculizumab Therapy: Insight Into Pathogenesis

依库珠单抗治疗后出现的播散性隐球菌病:发病机制洞察

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作者:Olivier Lortholary, Carine El-Sissy, Jérémie Leporrier, Sarah Sze Wah Wong, Eric Dannaoui, Véronique Fremeaux-Bacchi, Vishukumar Aimanianda

Abstract

Eculizumab, a recombinant humanized monoclonal antibody (mAb), is used for the treatment of patients (both adults and children) with paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome. This mAb binds to complement protein 5 (C5), thereby inhibiting its cleavage. On the other hand, one of the C5 cleavage products, C5a, is a potent anaphylatoxin with proinflammatory properties, involved in antimicrobial surveillance. Administration of eculizumab has been reported to make patients more susceptible to infection by encapsulated bacteria. Here, we are reporting an adult case of disseminated infection due to the encapsulated yeast Cryptococcus neoformans following eculizumab therapy and discuss its pathogenesis.

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