Diagnosis of de novo localized thrombotic microangiopathy by surveillance biopsy

M. Colleen Hastings, Robert J. Wyatt, Bettina H. Ault, Deborah P. Jones, Keith K. Lau, A. Osama Gaber, Lillian Gaber

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Thrombotic microangiopathy has been reported in association with calcineurin inhibitors and less frequently with sirolimus in renal transplant patients. The diagnosis of thrombotic microangiopathy is typically made by diagnostic biopsy in the setting of allograft dysfunction. The finding of thrombotic microangiopathy on surveillance biopsy without a significant elevation of baseline serum creatinine is unusual. The optimal treatment of this disorder remains controversial. Treatment strategies have included dose adjustment, drug substitution, plasmapheresis, and intravenous immunoglobulin G. We report a case of de novo thrombotic microangiopathy diagnosed by surveillance biopsy in a patient without hematologic abnormalities or elevated serum creatinine. This patient had resolution of the renal lesion following conversion from tacrolimus to sirolimus-based immunosuppression.

Original languageEnglish (US)
Pages (from-to)742-746
Number of pages5
JournalPediatric Nephrology
Volume22
Issue number5
DOIs
StatePublished - May 1 2007

Keywords

  • Calcineurin inhibitor
  • Hemolytic uremic syndrome
  • Renal transplantation
  • Sirolimus
  • Tacrolimus
  • Thrombotic microangiopathy

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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