Rapidly progressive glomerulonephritis, thrombotic microangiopathy and amebic colitis: a challenging case report

В статье описан «неклассический» случай, редко встречающаяся форма заболевания системной красной волчанкой без типичного поражения кожи с проявлением быстропрогрессирующего гломерулонефрита, с поражением тазобедренного сустава, выраженным болевым синдромом у юноши. С применением новых инновационных методов диагностики (непрямая иммунофлюоресценция на анализаторе AKLIDES), что позволило провести своевременно комплексную терапию включая в себя патогенетическую, эфферентную (гемодиализ, плазмаферез), тем самым получен хороший клинический эффект. This article describes a non- racial case of systemic lupus erythematosus with the manifestation of a rapidly progressive glomerulonephritis, hip joint lesion, a pronounced painful syndrom, without dermal manifestations. By the use of new diagnostic methods (immunofluorescence), timely complex therapy: pathogenetic, efferent therapy, symptomatic therapy, it is possible to obtain a fairly good clinical - laboratory- instrumental result.

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Thrombotic Microangiopathy Associated with Chemotherapy: Case Report and Review of the Literature

DICP ◽

10.1177/1060028089023007-810 ◽

1989 ◽

Vol 23 (7-8) ◽

pp. 582-588 ◽

Cited By ~ 9

Author(s):

Suzanne M. Fields ◽

Celeste M. Lindley

Keyword(s):

Case Report ◽

Thrombotic Microangiopathy ◽

English Literature ◽

Protein A ◽

Treatment Modalities ◽

Staphylococcal Protein A ◽

Von Willebrand ◽

Willebrand Factor ◽

Prostacyclin Production ◽

Immune Complex Formation

Thrombotic microangiopathy (TMA) is a serious toxicity associated with a small number of antineoplastic agents. A case report of a patient with probable cisplatin and bleomycin-induced TMA is presented. The basic triad of symptoms that occurs in the TMA syndrome include microangiopathic hemolytic anemia, thrombocytopenia, and renal impairment. Cardiovascular, pulmonary, and neurologic complications also occur frequently. The pathogenesis of chemotherapy-associated thrombotic microangiopathy (C-TMA) has not been established. Proposed mechanisms include von Willebrand Factor abnormalities, decreased prostacyclin production, and immune complex formation. Treatment modalities have been unsuccessful and the majority of patients reported have died. Immunoperfusion with staphylococcal protein A is the most effective treatment available and this new technique appears promising. This article reviews the results of all cases of C-TMA reported to date in the English literature and discusses the theories of pathogenesis, clinical features, treatment, and treatment-related complications of the syndrome.

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