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Annals of Clinical & Laboratory Science 36:319-325 (2006)
© 2006 Association of Clinical Scientists

Case Report

Chronic Active Thrombotic Microangiopathy in Native and Transplanted Kidneys

Ping L. Zhang1, Jeffery W. Prichard1, Fan Lin1, Michael F. Shultz2, Sayeed K. Malek3, John H. Shaw, IV4 and James E. Hartle2
1 Division of Laboratory Medicine, 2 Department of Nephrology, 3 Department of Transplantation, and 4 Weis Center for Research, Geisinger Medical Center, Danville, Pennsylvania

Address correspondence to Ping L. Zhang, M.D., Ph.D., Laboratory Medicine, Geisinger Medical Center, 100 North Academy, Danville, PA 17822, USA; tel 570 521 6333; fax 570 521 6105; e-mail plzhang{at}geisinger.edu.

We report 2 complicated cases of thrombotic microangiopathy with chronic features and active components. The first case was a 36-yr-old woman with positive anti-DNA antibody and possible lupus cerebritis, who developed thrombotic microangiopathy secondary to a series of syndromes, including preeclampsia and anti-phospholipid antibody syndrome. Renal biopsy revealed no evidence of lupus nephritis and her renal function returned to normal 1 week after the biopsy. The second case was a 46-yr-old man who developed thrombotic microangiopathy of unknown etiology, which led to end-stage renal disease within 6 mo. The patient received a living related-donor transplant, but thrombotic microangiopathy recurred in the donor kidney only 40 days after the renal transplantation.

Keywords: thrombotic microangiopathy, thrombocytopenia, preeclampsia, anti-phospholipid antibody syndrome, renal transplantation






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