Thrombotic Microangiopathy during Ganciclovir Treatment for Cytomegalovirus Infection in a Patient with Autologous Hematopoietic Stem Cell Transplantation / 임상소아혈액종양

ABSTRACT

Thrombotic microangiopathy (TMA) is a known complication of hematopoietic stem cell transplantation (HSCT). Here, we describe a case of TMA after autologous HSCT, which was associated with ganciclovir treatment. A 5-year-old boy presented with Coombs-negative hemolytic anemia, thrombocytopenia, gross hematuria, massive proteinuria, and hypertension during ganciclovir treatment after autologous HSCT. TMA was confirmed by renal biopsy which showed swelling of endothelial cells, occlusion of the glomerular lumina, duplication of glomerular basement membranes, and mesangiolysis. There was complete resolution of TMA in both laboratory and clinical manifestations after ganciclovir cessation only with supportive cares and hydration.