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Pulmonary tumor thrombotic microangiopathy: Two case reports and literature review.
Ma, Hua; Gao, Jian-Mei; Wang, Jing; Huang, Ling-Yan; Tian, Xing-Cang; Tian, Zhi-Gang; Wang, Shao-Jin; Ma, Gang; Tan, Hai; Zhang, Shu-Xiang.
Affiliation
  • Ma H; Clinical Medical College, Ningxia Medical University, Yinchuan, China.
  • Gao JM; Department of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, China.
  • Wang J; Clinical Medical College, Ningxia Medical University, Yinchuan, China.
  • Huang LY; Department of Pathology, General Hospital of Ningxia Medical University, Yinchuan, China.
  • Tian XC; Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China.
  • Tian ZG; Department of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, China.
  • Wang SJ; Department of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, China.
  • Ma G; Department of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, China.
  • Tan H; Department of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, China.
  • Zhang SX; Department of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, China.
Medicine (Baltimore) ; 103(26): e38618, 2024 Jun 28.
Article in En | MEDLINE | ID: mdl-38941435
ABSTRACT
RATIONALE Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but serious complication in patients with malignancy; its main manifestation includes acute pulmonary hypertension with severe respiratory distress. More than 200 cases have been reported since it was first identified in 1990. PTTM accounts for approximately 0.9% to 3.3% of deaths due to malignancy, but only a minority of patients are diagnosed ante-mortem, with most patients having a definitive diagnosis after autopsy. PATIENT CONCERNS Two middle-aged women both died within a short period of time due to progressive dyspnea and severe pulmonary hypertension. DIAGNOSES One patient was definitively confirmed as a gastrointestinal malignant tumor by liver puncture biopsy pathology. Ultimately, the clinical diagnosis was pulmonary tumor thrombotic microangiopathy.

INTERVENTIONS:

The patient was treated symptomatically with oxygen, diuresis, and anticoagulation, while a liver puncture was perfected to clarify the cause.

OUTCOMES:

Two cases of middle-aged female patients with rapidly progressive pulmonary hypertension and respiratory failure resulted in death with malignant neoplasm. LESSONS PTTM has a rapid onset and a high morbidity and mortality rate. Our clinicians need to be more aware of the need for timely diagnosis through a targeted clinical approach, leading to more targeted treatment and a better prognosis.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Thrombotic Microangiopathies Limits: Female / Humans / Middle aged Language: En Journal: Medicine (Baltimore) Year: 2024 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Thrombotic Microangiopathies Limits: Female / Humans / Middle aged Language: En Journal: Medicine (Baltimore) Year: 2024 Document type: Article Affiliation country: Country of publication: