Alternative complement cascade dysregulation is proposed to work in patients of HUS. Other complement pathways implicated in HUS are factor H, factor I, membrane cofactor protein and thrombomodulin (Kavanagh D et al. Ped Nephrol. 2010;25(12):2431-42). The complement blockade is considered to be ideal, but is usually not feasible. PEX and immunosuppression are satisfactory in the management of anti-FH HUS (European Guidelines 2009). Long-term monitoring for relapses is recommended; allograft recurrence may occur.