A Clinical Case of Atypical Hemolytic Uremic Syndrome in Remission: A Step Towards Personalized Treatment

Atypical hemolytic uremic syndrome (aHUS) is a rare, complement‑mediated thrombotic microangiopathy requiring early recognition and treatment. We present the case of a 57‑year‑old woman with aHUS triggered by a diarrheal illness, who developed acute kidney injury and hematological abnormalities. Eculizumab was initiated within 48 hours, alongside plasma exchange. The patient achieved hematologic remission within two weeks and recovered renal function within one month. Genetic testing revealed no pathogenic variants in complement‑related genes. Based on clinical stability and genetic findings, eculizumab was discontinued after six months. At the 12‑month follow‑up, the patient remained in remission with preserved renal function. This case supports the safety of eculizumab withdrawal in genetically negative aHUS under close monitoring.