[Transplantation-associated thrombotic microangiopathy confirmed by renal biopsy].
Rinsho Ketsueki
; 59(4): 389-394, 2018.
Article
en Ja
| MEDLINE
| ID: mdl-29743397
ABSTRACT
An eight-year-old girl with myelodysplastic syndrome (refractory cytopenia) received a bone marrow transplant (BMT) from an unrelated donor because of immunosuppressive therapy failure. Following administration of foscarnet for cytomegalovirus reactivation at day40 post-BMT, serum creatinine increased, and proteinuria, hematuria, and hypertension gradually exacerbated and became prolonged. However, neither schistocytosis nor other organ damage was evident. At six months post-BMT, renal biopsy revealed diffuse glomerular damage with glomerular lobulation, a double contour of the glomerular basement membrane, erythrocyte congestion and thrombi in the glomerular endocapillaries, and mesangiolysis, confirming the diagnosis of transplantation-associated thrombotic microangiopathy (TA-TMA). We initiated strict controls regarding fluid balance, salt intake, and blood pressure. The patient's renal function improved 10 months post-BMT. TA-TMA often presents as non-specific symptoms, making diagnosis difficult. In cases of post-transplant renal damage, TA-TMA should be differentiated regardless of whether specific symptoms such as hemolytic anemia and other organ failure are evident, and a renal biopsy should, therefore, be considered.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Trasplante de Médula Ósea
/
Microangiopatías Trombóticas
/
Enfermedades Renales
Tipo de estudio:
Risk_factors_studies
Límite:
Child
/
Female
/
Humans
Idioma:
Ja
Revista:
Rinsho Ketsueki
Año:
2018
Tipo del documento:
Article