Thrombotic Microangiopathy Secondary to Steroid Pulse Therapy Administered for Refractory Nephrotic Syndrome
| Autor: | Junya Yamamoto, Tomotsune Miyamoto, Yozo Ishikawa, Tsuyoshi Yamamura, Tetsuya Kawata |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Nephrotic Syndrome Thrombotic microangiopathy medicine.medical_treatment ADAMTS13 Protein Kidney urologic and male genital diseases Gastroenterology Renal Dialysis Internal medicine Edema Internal Medicine medicine Humans Aged Proteinuria Plasma Exchange medicine.diagnostic_test Thrombotic Microangiopathies business.industry Stupor Acute kidney injury Brain General Medicine medicine.disease Magnetic Resonance Imaging ADAM Proteins Female Steroids Renal biopsy Hemodialysis medicine.symptom business Nephrotic syndrome |
| Zdroj: | Internal Medicine. 52:2099-2103 |
| ISSN: | 1349-7235 0918-2918 |
| Popis: | A 79-year-old woman with familial hyperlipidemia was treated with low-density lipoprotein apheresis. She was hospitalized due to fatigue and edema, and massive proteinuria was discovered. Renal biopsy revealed no distinct abnormalities, thus suggesting a diagnosis of minimal change nephrotic syndrome. She developed acute kidney injury and hemodialysis was initiated. Two series of steroid pulse therapy were given, but the proteinuria did not decrease. Thereafter, she developed thrombocytopenia and fell into a stupor. Thrombotic microangiopathy (TMA) was the most likely diagnosis. Plasma exchange was initiated, resulting in improvements in platelet counts and in her level of consciousness. Clinicians should therefore be aware that TMA can occur as a result of steroid pulse therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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