Toddler With New Onset Diabetes and Atypical Hemolytic-Uremic Syndrome in the Setting of COVID-19

• DOI: 10.1542/peds.2020-016774
• Publication Date: 2020-10-09T12:25:13Z
• Authors: Faraz Alizadeh; Amanda O’Halloran; Areej Alghamdi; Charlotte Chen; Maria Trissal; Avram Traum; Danielle DeCourcey
• Keywords: Eculizumab; Microangiopathic hemolytic anemia; Failure to Thrive

This is a novel case of 16-month-old boy with history prematurity intrauterine growth restriction, severe failure to thrive, microcephaly, pachygyria, agenesis the corpus callosum, and postnatal embolic stroke, who presented new-onset diabetes mellitus diabetic ketoacidosis in setting acute respiratory syndrome coronavirus 2 infection, course complicated by atypical hemolytic (aHUS). patient demonstrated remarkable insulin resistance period before aHUS diagnosis, which resolved first dose eculizumab therapy. There increasing evidence that COVID-19 associated thrombotic disorders microangiopathic processes complement-mediated inflammation may be implicated. In this report, we describe pediatric new disease. Because whole-exome sequencing extensive workup returned without clear etiology for aHUS, likely triggered versus an idiopathic was unmasked infection.