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Record W4409300339 · doi:10.1016/j.phrs.2025.107714

Multidisciplinary consensus on the diagnosis and management of patients with atypical Hemolytic Uremic Syndrome (complement-mediated TMA): Recommendations from Italian scientific societies, patient associations and regulators

2025· review· en· W4409300339 on OpenAlexaff
Emma Diletta Stea, Mariateresa Pugliano, Roberta Gualtierotti, Monica Mazzucato, Luisa Santangelo, Giuseppina Annicchiarico, Alfredo Berardelli, Stefano Bianchi, Laura Bogliolo, Paolo Chiandotto, Giuseppe Cirino, Fabio De Iaco, Silvia De Rosa, Paola Facchin, Ennio Giulio Favalli, Francesco Fiorin, Antonino Giarratano, Claudia Laterza, Michelangelo Mancuso, Alessandro Padovani, Andrea Pasini, Annalisa Scopinaro, Gian Domenico Sebastiani, Giorgio Sesti, Beniamino Susi, Antonio Torsello, Cinzia Vezzoni, Luca Zanlari, Loreto Gesualdo, Annamaria De Luca

Bibliographic record

VenuePharmacological Research · 2025
Typereview
Languageen
FieldImmunology and Microbiology
TopicComplement system in diseases
Canadian institutionsUniversity Hospital Foundation
FundersEuropean Rare Kidney Disease Reference NetworkMinistero dell’Istruzione, dell’Università e della RicercaFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoAlexion Pharmaceuticals
KeywordsMultidisciplinary approachComplement (music)Consensus conferenceMedicineIntensive care medicineComplement systemAtypical hemolytic uremic syndromeImmunologyPolitical scienceInternal medicineLawBiologyGenetics

Abstract

fetched live from OpenAlex

Atypical Hemolytic Uremic Syndrome (aHUS) is a severe, systemic, rare disease (RD) that can occur in people of all ages, and is associated with high rates of morbidity and mortality. Because the management of patients with aHUS can be difficult, more effective strategies should be implemented. Faculty members from several Italian Scientific Societies, Patient Associations and Regional Institutional Experts on RDs met to discuss aHUS management within a multidisciplinary team (MDT), using a Delphi process to develop consensus recommendations. Consensus (≥70 % agreement by faculty members) was reached on 51 statements with the aim of improving patient management and outcomes. These statements provide a unified framework for the differential diagnosis of aHUS, prompt recognition of the pathology, referral to RD reference centers, selecting between treatment relapse prevention measures options, patient management by a MDT and improving the overall awareness of aHUS. Despite the broad scope of the consensus statements, several unmet needs in the management of patients with aHUS were identified, including diagnostic suspicion, rapid genetic investigations, regular review of the centers of expertise (considering the number of treated patients), permanent clinical referral in treatment centers and widespread expertise among adult and pediatric specialists. We hope that this standardized framework will form the basis of the "digital ecosystem" concept and development of possible information technology solutions to assist the MDT involved in the management of patients with aHUS.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.290
Threshold uncertainty score0.998

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0010.001
Scholarly communication0.0000.000
Open science0.0000.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.170
GPT teacher head0.428
Teacher spread0.258 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations6
Published2025
Admission routes1
Has abstractyes

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