A Case of Thrombotic Microangiopathy Following Autologous Stem Cell Transplantation
- Author:
Jung Yoon CHOI
1
;
Ji Won LEE
;
Hee Young JU
;
Che Ry HONG
;
Hyery KIM
;
Dong Soon LEE
;
Nam Hee KIM
;
Hyoung Jin KANG
;
Kyung Duk PARK
;
Hee Young SHIN
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. hyshin@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Thrombotic microangiopathy;
Autologous stem cell transplantation;
Plasmapheresis;
Pediatrics
- MeSH:
Anemia, Hemolytic;
Child, Preschool;
Early Intervention (Education);
Fever;
Hematopoietic Stem Cell Transplantation;
Humans;
Male;
Medulloblastoma;
Methylprednisolone;
Pediatrics;
Plasmapheresis;
Posterior Leukoencephalopathy Syndrome;
Respiratory Distress Syndrome, Adult;
Stem Cell Transplantation;
Thrombospondins;
Thrombotic Microangiopathies
- From:Clinical Pediatric Hematology-Oncology
2014;21(2):140-144
- CountryRepublic of Korea
- Language:English
-
Abstract:
Transplantation-associated thrombotic microangiopathy (TA-TMA) is an uncommon but devastating complication in patients who undergo hematopoietic stem cell transplantation (SCT). However, the optimal treatment strategy for TA-TMA is unclear. We report a rare case of TA-TMA in a 39-month-old boy who underwent tandem autologous SCT (autoSCT) for high-risk medulloblastoma. TA-TMA developed 64 days after the second autoSCT with microangiopathic hemolytic anemia, fever, renal impairment, acute respiratory distress syndrome and posterior reversible encephalopathy syndrome. The patient recovered after plasmapheresis and methylprednisolone therapy. He had mild to moderate deficiency of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13). The patient's clinical course would suggest that plasmapheresis and methylprednisolone therapy could be a treatment option for TA-TMA. Early intervention is needed to aid the recovery of the patient who is suspected for TA-TMA.
