Disseminated histoplasmosis presenting as thrombotic microangiopathy.

Abstract:

BACKGROUND:Thrombotic microangiopathies (TMA) are systemic vasoocclusive disorders associated with significant morbidity and mortality. Rapid and reliable diagnosis of TMA is critical. The diagnosis is complicated by a lack of objective and sensitive laboratory testing as well as multiple concurrent diseases, including infectious processes. CASE STUDY:We report two cases of disseminated histoplasmosis associated with TMA manifestations in renal transplant recipients, including one patient with histologically documented renal microthrombi; both patients were referred for plasma exchange. After the diagnosis of histoplasmosis, the treatment plan was changed to antifungal medications, reduced immuno-suppression, and supportive care, with progressive resolution of TMA manifestations. CONCLUSION:TMA occurs in transplant populations in association with infections, medications, and other factors. Appropriate management includes recognition and treatment of possible etiological factors. Disseminated histoplasmosis should be considered in transplant patients presenting with TMA.

journal_name

Transfusion

journal_title

Transfusion

authors

Dwyre DM,Bell AM,Siechen K,Sethi S,Raife TJ

doi

10.1111/j.1537-2995.2006.00873.x

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

1221-5

issue

7

eissn

0041-1132

issn

1537-2995

pii

TRF00873

journal_volume

46

pub_type

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