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...
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| Veröffentlicht in: | BMJ case reports 2018-12, Vol.11 (1), p.e226707 |
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| creator | Vilayur, Eswari de Malmanche, Jillian Trevillian, Paul Ferreira, David |
| description | 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. |
| doi_str_mv | 10.1136/bcr-2018-226707 |
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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.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-226707</identifier><identifier>PMID: 30567242</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>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</subject><ispartof>BMJ case reports, 2018-12, Vol.11 (1), p.e226707</ispartof><rights>BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2018 BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3297-1bfc4071405d657ca9516ad19fa1b42de57705c3eefebdbb9bb9491be38243d83</citedby><cites>FETCH-LOGICAL-b3297-1bfc4071405d657ca9516ad19fa1b42de57705c3eefebdbb9bb9491be38243d83</cites><orcidid>0000-0003-3142-4503</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301462/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301462/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30567242$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vilayur, Eswari</creatorcontrib><creatorcontrib>de Malmanche, Jillian</creatorcontrib><creatorcontrib>Trevillian, Paul</creatorcontrib><creatorcontrib>Ferreira, David</creatorcontrib><title>Metastatic lung adenocarcinoma- associated thrombotic microangiopathy in a renal transplant recipient</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>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.</description><subject>Adenocarcinoma of Lung - etiology</subject><subject>Anemia</subject><subject>Anticoagulants</subject><subject>Antigens</subject><subject>Biochemistry</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Case reports</subject><subject>Chemotherapy</subject><subject>Dehydrogenases</subject><subject>Edema</subject><subject>Family medical history</subject><subject>Hemoglobin</subject><subject>Histology</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Laboratories</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Neoplasm Metastasis</subject><subject>Postoperative Complications - etiology</subject><subject>Prostate</subject><subject>Rare Disease</subject><subject>Systematic review</subject><subject>Thrombotic Microangiopathies - etiology</subject><subject>Transplants & implants</subject><subject>Ultrasonic imaging</subject><subject>Veins & arteries</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkc9rFTEQx4MottSevcmCFxHW5udmcxGkqC1UvCh4C5Ns9r08dpM1yRb635vl1VK9NAQSJp_5Zma-CL0m-AMhrLswNrUUk76ltJNYPkOnRArZSoV_PX90P0HnOR9wXYzwnrOX6IRh0UnK6Sly31yBXKB420xr2DUwuBAtJOtDnKFtIOdoPRQ3NGWf4mzihs7epghh5-MCZX_X-NBAk1yAqSkJQl4mCKUGrF-8C-UVejHClN35_XmGfn75_OPyqr35_vX68tNNaxhVsiVmtBxLwrEYOiEtKEE6GIgagRhOByekxMIy50ZnBmNU3VwR41hPORt6doY-HnWX1cxusPXrBJNekp8h3ekIXv_7Evxe7-Kt7hgmvKNV4N29QIq_V5eLnn22bqrtuLhmTYlQjGLZ44q-_Q89xDXVCWyUEr1QhKonKC45F3TTujhSdao5Jzc-lEyw3rzW1Wu9ea2PXteMN487feD_OluB90fAzIcn1f4AK5uztg</recordid><startdate>20181213</startdate><enddate>20181213</enddate><creator>Vilayur, Eswari</creator><creator>de Malmanche, Jillian</creator><creator>Trevillian, Paul</creator><creator>Ferreira, David</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3142-4503</orcidid></search><sort><creationdate>20181213</creationdate><title>Metastatic lung adenocarcinoma- associated thrombotic microangiopathy in a renal transplant recipient</title><author>Vilayur, Eswari ; 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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.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30567242</pmid><doi>10.1136/bcr-2018-226707</doi><orcidid>https://orcid.org/0000-0003-3142-4503</orcidid><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | Metastatic lung adenocarcinoma- associated thrombotic microangiopathy in a renal transplant recipient |
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