A Rare Case of Colic Thrombotic Microangiopathy in Renal Transplantation

• Published in: Transplantation proceedings Vol. 42; no. 4; pp. 1362 - 1364
• Main Authors: Rizza, V, Coletti, G, Mazzotta, C, Clemente, K, Di Cocco, P, Del Reno, F, Margiotta, G, Famulari, A, Pisani, F
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.05.2010; Elsevier
• Subjects: Abscess - pathology; Anemia - etiology; Arteries - pathology; Bilirubin - blood; Biological and medical sciences; Colitis, Ulcerative - pathology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Granulocytes - pathology; Humans; Iron - blood; Kidney Transplantation - adverse effects; Male; Medical sciences; Middle Aged; Platelet Count; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Thrombotic Microangiopathies - etiology; Thrombotic Microangiopathies - pathology; Tissue, organ and graft immunology; Transplantation, Homologous; Digestive system; Gut; Cardiovascular disease; Homotransplantation; Thrombohemolytic microangiopathy; Kidney; Vascular disease; Case study; Medicine; Treatment; Urinary system; Surgery; Graft; Colon; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.03.083

Abstract Introduction We report a case of thrombotic microangiopathy (TM) in patient with UC and kidney transplantation. Case Report A 59-year-old Caucasian may with a renal transplant, with atrial fibrillation and ulcerative colitis (UC), was referred for asthenia, fever (38°C), anemia, colicky pain, and bloody diarrhea. The maintenance therapy consisted of CSA, sodium mycophenolate, steroids, ticlopidine, and mesalazine. Laboratory data, colonscopy, and colic mucosal biopsy revealed de novo colic TM. We administered antibiotics and antishock therapy, reducing CSA, withdrawing ticlopedine and maintaining mesalazine with the resolution of the problem. Conclusion Posttransplantation TM is an uncommon but severe complication of kidney transplantation associated with reduced graft survival and a high risk for death. Only an early, accurate diagnosis with optimal treatment permits resolution of the problem.