Kidney-limited thrombotic microangiopathy in patients with SLE treated with romiplostim

被引：11
|
作者：
Tomov, S. [1 ]
Lazarchick, J. [2 ]
Self, S. E. [2 ]
Bruner, E. T. [2 ]
Budisavljevic, M. N. [1 ,3 ]
机构：
[1] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA
[2] Pathol & Lab Med Med Univ South Carolina, Charleston, SC USA
[3] Ralph H Johnson VA Med Ctr, Charleston, SC USA
来源：
LUPUS | 2013年 / 22卷 / 05期
关键词：
Thrombotic microangiopathy; antiphospholipid syndrome; thrombotic thrombocytopenic purpura; romiplostim; acute renal failure; systemic lupus erythematosus; plasma exchange; SYSTEMIC-LUPUS-ERYTHEMATOSUS; THROMBOCYTOPENIC PURPURA; ANTIPHOSPHOLIPID SYNDROME; HEMOLYTIC-ANEMIA; VASCULAR-LESIONS; NEPHRITIS; THROMBOPOIETIN; ANTIBODIES;
D O I：
10.1177/0961203313477900
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
We present the case of a 19 year-old Caucasian female with history of systemic lupus erythematosus (SLE) and normal baseline kidney function who developed severe acute renal failure following treatment of thrombocytopenia with the thrombopoietic agent romiplostim. Percutaneous kidney biopsy revealed thrombotic microangiopathy (TMA) without immune complex lupus glomerulonephritis. We discuss pathogenesis and differential diagnosis of TMA in patients with SLE and raise concerns regarding the use of thrombopoietic agents in such patients. Based on favorable long-term outcome in our case aggressive treatment and in particular prolonged use of plasma exchange in these patients are advocated. Lupus (2013) 22, 504-509.
引用
收藏
页码：504 / 509
页数：6
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