Metastatic lung adenocarcinoma- associated thrombotic microangiopathy in a renal transplant recipient

Thrombotic microangiopathy (TMA) after renal transplantation can be a diagnostic challenge. TMA can occur with calcineurin inhibitors, allograft rejection, infection, mutations in complement regulatory proteins and autoimmunity. A 52-year-old male renal transplant recipient presented with extensive...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2018-12, Vol.11 (1), p.e226707
Main Authors: Vilayur, Eswari, de Malmanche, Jillian, Trevillian, Paul, Ferreira, David
Format: Article
Language:English
Subjects:
Adenocarcinoma of Lung - etiology
Anemia
Anticoagulants
Antigens
Biochemistry
Biopsy
Cancer
Case reports
Chemotherapy
Dehydrogenases
Edema
Family medical history
Hemoglobin
Histology
Humans
Immunoglobulins
Kidney Transplantation - adverse effects
Laboratories
Lung cancer
Lung Neoplasms - etiology
Male
Middle Aged
Monoclonal antibodies
Neoplasm Metastasis
Postoperative Complications - etiology
Prostate
Rare Disease
Systematic review
Thrombotic Microangiopathies - etiology
Transplants & implants
Ultrasonic imaging
Veins & arteries
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Thrombotic microangiopathy (TMA) after renal transplantation can be a diagnostic challenge. TMA can occur with calcineurin inhibitors, allograft rejection, infection, mutations in complement regulatory proteins and autoimmunity. A 52-year-old male renal transplant recipient presented with extensive deep vein thrombosis. He developed transfusion-dependent microangiopathic haemolytic anaemia with thrombocytopenia. He did not respond calcineurin inhibitor cessation, eculizumab or plasma exchange. ADAMTS13 and complement levels were normal. Infection and autoimmune screens were negative. A diagnosis of metastatic adenocarcinoma was made on bone marrow biopsy. This represents a rare case of malignancy-associated TMA in a renal transplant recipient. Early diagnosis can facilitate the prompt initiation of chemotherapy which is the only treatment option.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-226707