Therapeutic Orientation Test in Thrombotic Microangiopathy (TOTEM)

University Hospital Center (CHU)

Status: Enrolling

Conditions: Thrombotic Micro-angiopathy

Treatments: Diagnostic Test: Therapeutic orientation test for TMA

Study type: Interventional

Funder types: Other

Identifiers

NCT04777435

RECHMPL19_0075

Details and patient eligibility

About

Haemolytic and Uraemic Syndrome (HUS) is a serious disease requiring rapid diagnosis and management. The atypical HUS diagnosis has been greatly improved by anti-CS antibody (Eculizumab) wich block alternative complement pathway activation. To rise treatment success, Eculizumab introduction should be as early as possible. In some secondary HUS (infection, drugs...) complement is also involved as "second-hit".

To date, there is no tool to confirm complement involvement in a HUS at diagnosis stage. This study suggest to evaluate a therapeutic orientation test, in order to determine the complement implication in HUS diagnosis. The test evaluates the complement deposits on endothelial cell surface in vitro, compared to a normal human serum.

In order to determine the test performance, first the positive or negative results will be compared to the HUS clinical evolution, treated or not by the clinician with Eculizumab. Second, the test results will be compared to the presence of alternative complement pathway regulation abnormalities.

Enrollment: 100 estimated patients

Sex: All

Ages: Under 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

TMA with:

• mechanic haemolytic anemia, undetectable haptoglobin, LDH>1.5*LNS
• thrombopenia
• acute kidney injury TMA on native kidney or in post-transplantation.

Exclusion criteria

• DIVC patients
• plasma exchange during 1 month before sample collection
• treatment by Eculizumab before sample collection
• no consent
• not beneficiary of a social security
• pregnancy or breastfeeding
• patient Under guardianship

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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100 participants in 1 patient group

Patients with Thrombotic micro-angiopathy

Experimental group

Treatment:

Diagnostic Test: Therapeutic orientation test for TMA