Journal of Nephrology

, Volume 32, Issue 1, pp 17–25 | Cite as

Eculizumab in pregnancy: a narrative overview

  • Laura Sarno
  • Antonella Tufano
  • Giuseppe Maria Maruotti
  • Pasquale Martinelli
  • Mario M. Balletta
  • Domenico RussoEmail author
Part of the following topical collections:
  1. Obstetric Nephrology


Pregnancy can be a dangerous trigger for patients with paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), or hemolysis, elevated liver enzymes and low platelet (HELLP) syndrome. Due to the possibility of several serious complications, pregnancy is somewhat discouraged in the presence of the above diseases. Eculizumab is a humanized antibody that may dramatically change the clinical course of PNH, aHUS and HELLP syndrome. However, data on the safety of eculizumab in pregnancy are scarce. In this narrative overview, we summarize current evidence on the use of eculizumab during pregnancy in women with PNH, aHUS and HELLP syndrome. Eculizumab is not present in breast milk, and the levels observed in umbilical cord blood samples are not sufficient to affect the concentrations of complement in newborns. Therefore, eculizumab may be regarded as safe in pregnancy. Nonetheless, given that data on eculizumab in pregnancy are limited, it is not possible to completely exclude risks for both mother and fetus in treating PNH, aHUS and HELLP syndrome.


Atypical hemolytic uremic syndrome Paroxysmal nocturnal hemoglobinuria Eculizumab Pregnancy 


Compliance with ethical standards

Conflict of interest

All authors declare that they do not have conflict of interest.

Ethical statement

Authors of papers that have been cited in the present review have declared that their studies have been approved by the appropriate institutional and/or national research ethics committee and have been performed in accordance with ethical standards.

Informed consent

There is no requirement for an informed consent form, this manuscript being a literature review.


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Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  1. 1.Department of Neurosciences, Dentistry and Reproductive SciencesUniversity Federico IINaplesItaly
  2. 2.Department of Clinical Medicine and Surgery, Regional Reference Centre for Coagulation DisordersUniversity Federico IINaplesItaly
  3. 3.Department of Public HealthUniversity Federico IINaplesItaly

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