The potential role of complements in cocaine-induced thrombotic microangiopathy

Abstract Thrombotic microangiopathy (TMA) is a rare disorder characterized by microvascular injury and occlusion resulting in tissue ischemia and dysfunction. TMA occurs in a variety of settings including cocaine use. Although cocaine is widely used in the United States, cocaine-associated TMA is on...

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Bibliographic Details
Published in:Clinical kidney journal 2018-02, Vol.11 (1), p.26-28
Main Authors: Dejman, Adriana, Alavi, Seyed Navid, Thomas, David B, Stefanovic, Alexandra, Asif, Arif, Nayer, Ali
Format: Article
Language:English
Subjects:
AKI
Cocaine
Eculizumab
Endothelium
Ischemia
Kidney failure
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Summary:Abstract Thrombotic microangiopathy (TMA) is a rare disorder characterized by microvascular injury and occlusion resulting in tissue ischemia and dysfunction. TMA occurs in a variety of settings including cocaine use. Although cocaine is widely used in the United States, cocaine-associated TMA is only rarely reported. Therefore, other factors may predispose cocaine users to the development of TMA. Emerging evidence indicates that cocaine activates complements. Therefore, complement activation may contribute to the development of cocaine-induced TMA. Here, we report a cocaine user who presented with renal failure. Renal biopsy demonstrated TMA. Laboratory tests revealed reduced serum complement C3 and normal complement C4 levels indicative of alternative complement activation. We postulate that complement activation is involved in the pathogenesis of cocaine-induced TMA.
ISSN:2048-8505
2048-8513
DOI:10.1093/ckj/sfx061