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A 30-year-old female patient is seen for evaluation of fatigue. Initial labs show a hemo globin of 7.6 g/dl, MCV of 106 FL. WBC of 3,200/,LLL. and platelets of 178.000/,LLL. LDH is 1 .200 U/L and haptoglobin is low. On review of symptoms, she states that her urine is dark in the morning, but clears toward the evening. Test tubes showing serial urine samples are shown below.
She was started on eculizumab. What is the mechanism of action of this agent?
- Anti-CD52 antibody
- Anticomplement protein CS
- Inhibits production of multiple opsonization molecules
- Allosteric inhibition ofT-cell antigen receptors
Medicine
B. Eculizumab is a humanized monoclonal antibody that binds to CS, preventing its activa tion to CSb, and hence inhibiting the formation of the membrane attack complex. Treatment with ecu lizumab ameliorates hemolytic anemia and decreases transfusion requirements and thromboembolic events. It is not beneficial in patients who have bone marrow failure. Alemtuzumab is a monoclonal antibody against CD 52 that has been used in the treatment oflymphoproliferative disorders.
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