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Two unusual cases of autologous HSCT related TMA with kidney injury.

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机构: [1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China [2]Department of Nephrology, Peking Union Medical College, Beijing, China
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关键词: Kidney injury transplant autologous transplant-associated thrombotic microangiopathy case report

摘要:
Kidney injury caused by transplant-associated thrombotic microangiopathy (TA-TMA) in patients who underwent allogeneic hematopoietic stem cell transplantation (allo HSCT) is relatively frequent. However, it is rarely reported in patients undergoing autologous HSCT (aHSCT). There are a few studies reported that TA-TMA could occur in pediatric patients undergoing aHSCT, but the condition in adult patients is rarely described. Furthermore, almost all the patients who suffered from TA-TMA developed typical and severe manifestations which should be treated with aggressive target therapy. Nevertheless, we presented two cases of kidney injury caused by TA-TMA after aHSCT with specific clinical features. Case 1, a 33-year-old Chinese male diagnosed with Hodgkin's lymphoma developed TA-TMA -associated kidney injury 4 months after transplantation. Case 2, a 49-year-old Chinese female with central nervous lymphoma developed TA-TMA-related kidney injury 3 months after transplantation. Both patients presented "mild" and atypical features of TA-TMA and their kidney function was managed effectively with low-dose prednisone therapy. TA-TMA related kidney injury can occur in patients who underwent aHSCT. Patients with TA-TMA could develop atypically "mild" features. Low-dose prednisone may be effective in place of routine eculizumab treatment regimen. We recommend that clinicians prompt an investigation for TA-TMA in patients presenting kidney injury in the background of aHSCT to facilitate early diagnosis.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 4 区 卫生保健与服务
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Q3 HEALTH CARE SCIENCES & SERVICES
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第一作者机构: [1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
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通讯机构: [1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China [*1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Changchun Street 45#, Xicheng District, Beijing 100053, China
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