[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-443733-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-443733-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","crovalimab-rescue-therapy-in-a-case-with-genetic-complement-mediated-thrombotic-microangiopathy","Crovalimab Rescue Therapy in a Case With Genetic Complement Mediated Thrombotic Microangiopathy","","Complement mediated thrombotic microangiopathy (C-TMA) is a rare disorder that can lead to kidney failure and multi-organ manifestations. The case describes a young adult man with genetic C-TMA due to a likely pathogenic CFH missense variant who developed acute kidney injury, microangiopathic hemolysis, and nephrotic-range proteinuria after a prolonged remission. Plasma therapy and ravulizumab failed, hemolysis persisted, and complement assays showed inadequate inhibition and low drug exposure. Crovalimab improved hemolysis promptly and restored kidney function after months of dialysis, with continued recovery over 1 year.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/crovalimab-rescue-therapy-in-a-case-with-genetic-complement-mediated-thrombotic-microangiopathy/443733/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/crovalimab-rescue-therapy-in-a-case-with-genetic-complement-mediated-thrombotic-microangiopathy/443733.png","ImageObject",300,407,{"name":42,"@type":43},"WPS_1786070896","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What condition is described in this case report?","Question",{"text":63,"@type":64},"The report describes genetic complement mediated thrombotic microangiopathy (GC-TMA), a rare complement-driven disease causing microangiopathic hemolysis and kidney injury.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why was crovalimab started?",{"text":68,"@type":64},"Crovalimab was initiated after plasma therapy and ravulizumab failed to halt hemolysis, with evidence of insufficient complement inhibition and low circulating ravulizumab concentrations.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the treatment outcomes after crovalimab?",{"text":72,"@type":64},"Hemolysis improved immediately, kidney function recovered after about 3 months of dialysis, and improvements continued throughout 1 year of crovalimab therapy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},443733,1791302704,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":123,"preview_page_count":4},549768072016,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Case Report  \nCrovalimab Rescue Therapy in a Case With Genetic Complement Mediated Thrombotic Microangiopathy  \nChristof Aigner, Zoltn Prohszka, gnes Szilgyi, Georg A. B€ohmig, Klaus Arbeiter, Alice Schmidt, and Gere Sunder-Plassmann  \nComplement mediated thrombotic microangiopathy (C-TMA) is a rare disease resulting in kidney failure and other organ manifestations. Current treatments include the complement C5 blockers eculizumab and ravulizumab as well as plasma therapy. We report on a young adult man with a long-standing history of genetic C-TMA (GC-TMA) because of a likely pathogenic missense variant in CFH. After several years without clinical signs of TMA and normal kidney function (CKD G1A2), without recent specific therapies, he presented with acute kidney injury, microangiopathic hemolysis, and nephrotic range proteinuria. Plasma therapy and ravulizumab failed to stop hemolysis, and he commenced kidney replacement therapy 11 days after admission. Laboratory analyses disclosed suboptimal complement inhibition and low free ravulizumab serum concentrations. Four weeks after admission, we started treatment with crovalimab, a novel humanized anti-C5 antibody. Hemolysis improved immediately and kidney function recovered after 3 months of dialysis treatment and improved continuously during 1 year of therapy with crovalimab. The excellent and rapid response to crovalimab potentially suggests that the engineering of crovalimab, facilitating also subcutaneous administration, may result in a different pharmacokinetic and pharmacodynamic profile of crovalimab as compared with standard C5 inhibitors in patient with nephrotic range proteinuria.  \nComplete author and article information provided before references.  \nCorrespondence to  \nC. Aigner (christof.aigner@ [meduniwien.ac.at](meduniwien.ac.at)) Kidney Med. 8(1):101185. Published online November  \n10, 2025.  \ndoi: 10. 1016/  \nj.xkme.2025.101185  \n© 2025 The Authors. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)).  \nUncontrolled activation of the complement system plays  \na causal role in complement mediated thrombotic microangiopathy (C-TMA) and C3 glomerulopathy and also contributes to injury in numerous other kidney diseases. 1 , 2 Fortunately, the last years have witnessed the clinical development of an evolving number of complement modulators beneath the well-established complement C5 blockers eculizumab and ravulizumab, which is engineered from eculizumab, resulting in a molecule that targets the same epitope as eculizumab with an extended half-life.3-5 One of these molecules is crovalimab, a novel humanized anti-C5 antibody, that is successfully used subcutaneously in C5 inhibitor naive and pretreated patients with paroxysmal nocturnal hematuria.6 Crovalimab is engineered using the sequential monoclonal antibody recycling technologyimmunoglobulin. This technique allows for combined isoelectric point- , neonatal Fc receptor- , and pHdependent affinity engineering to prolong antibody half-life in the plasma and reduce the drug dosage.7 Crovalimab further binds to the C5 β-chain, which is a different epitope from eculizumab and ravulizumab. It thus inhibits C5 activation in patients carrying the C5 variant p. (Arg885His), p. (Arg885Ser), or p. (Arg885-Cys) located in the C5 α-chain, which confer resistance to eculizumab and ravulizumab.8-11  \nWe report, to the best of our knowledge, the first case of genetic C-TMA (GC-TMA) that responded to treatment with crovalimab after failure of ravulizumab and plasma therapy.  \nCASE REPORT  \nA 23-year-old man of Asian descent presented to the emergency department with a history of fever since about 2 weeks, headache, and weakness in the legs. His height was 1.80 m, and his body weight 60 kg. His blood pressure was 150 over 100 mm Hg, with normal heart rate, body ","cbCaitGBrjb3apjr","https://ap.wps.com/l/cbCaitGBrjb3apjr","pdf",576481,"English","# Case Report\n## Presentation and baseline history\n## Initial treatments and diagnostic findings\n## Crovalimab rescue therapy and outcomes","[{\"question\":\"What condition is described in this case report?\",\"answer\":\"The report describes genetic complement mediated thrombotic microangiopathy (GC-TMA), a rare complement-driven disease causing microangiopathic hemolysis and kidney injury.\"},{\"question\":\"Why was crovalimab started?\",\"answer\":\"Crovalimab was initiated after plasma therapy and ravulizumab failed to halt hemolysis, with evidence of insufficient complement inhibition and low circulating ravulizumab concentrations.\"},{\"question\":\"What were the treatment outcomes after crovalimab?\",\"answer\":\"Hemolysis improved immediately, kidney function recovered after about 3 months of dialysis, and improvements continued throughout 1 year of crovalimab therapy.\"}]","Crovalimab Rescue Therapy in a Case With Genetic Complement Mediated Thrombotic Microangiopathy | PDF",1790705160]