Thrombotic microangiopathy with renal involvement complicated by hematopoietic stem cell transplantation: a case report and literature review
10.3760/cma.j.cn441217-20240909-00913
- VernacularTitle:造血干细胞移植并发肾脏受累的血栓性微血管病1例暨文献复习
- Author:
Weiying LIU
1
;
Jianwen YU
;
Tong WU
;
Ya LI
;
Yuchu LIU
;
Yan XU
;
Fengxian HUANG
;
Wei CHEN
;
Naya HUANG
Author Information
1. 中山大学附属第一医院肾内科 国家卫生健康委员会肾脏病临床研究重点实验室（中山大学）广东省肾脏病重点实验室，广州 510080
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Thrombotic microangiopathies;
Kidney diseases;
Renal pathology
- From:
Chinese Journal of Nephrology
2025;41(9):696-701
- CountryChina
- Language:Chinese
-
Abstract:
This article reports a rare case of thrombotic microangiopathy (TMA) with renal involvement complicated by allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient appeared increased serum creatinine 20 d after allo-HSCT, and gradually appeared hypertension, oliguria and edema. Despite discontinuing suspected medications, serum creatinine level did not decrease. Treatment with basiliximab and mycophenolate mofetil was initiated to prevent rejection, leading to gradual normalization of urine output and serum creatinine level. However, after stopping mycophenolate mofetil, the patient experienced recurrent increased blood pressure and decreased pulse oximetry, responding well to prednisone but recurring upon cessation, with gradually increased serum creatinine level. Renal pathology indicated that chronic TMA after allo-HSCT caused renal injury, primarily affecting the glomeruli. The renal function achieved long-term stability through low-dose prednisone and symptomatic treatment. By reviewing relevant literature, we discussed the clinical manifestations, laboratory tests, pathological features and treatment strategies of TMA with renal involvement complicated by allo-HSCT.
