机构:[1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China内科系统肾科首都医科大学宣武医院[2]Department of Nephrology, Peking Union Medical College, Beijing, China
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.
基金:
This study is supported by Xuanwu Hospital Huizhi talent leader training program to Prof. Aihua Zhang.
第一作者机构:[1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
通讯作者:
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
推荐引用方式(GB/T 7714):
Dong Xingtong,Jia Qiang,Fu Wenjing,et al.Two unusual cases of autologous HSCT related TMA with kidney injury.[J].ANNALS OF PALLIATIVE MEDICINE.2022,11(4):1546-1553.doi:10.21037/apm-21-226.
APA:
Dong Xingtong,Jia Qiang,Fu Wenjing,Li Yinping,Lin Na...&Zhang Aihua.(2022).Two unusual cases of autologous HSCT related TMA with kidney injury..ANNALS OF PALLIATIVE MEDICINE,11,(4)
MLA:
Dong Xingtong,et al."Two unusual cases of autologous HSCT related TMA with kidney injury.".ANNALS OF PALLIATIVE MEDICINE 11..4(2022):1546-1553