RT Journal Article
SR Electronic
T1 Metastatic lung adenocarcinoma- associated thrombotic microangiopathy in a renal transplant recipient
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e226707
DO 10.1136/bcr-2018-226707
VO 11
IS 1
A1 Vilayur, Eswari
A1 de Malmanche, Jillian
A1 Trevillian, Paul
A1 Ferreira, David
YR 2018
UL http://casereports.bmj.com/content/11/1/e226707.abstract
AB 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.