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A 3-year follow-up of a patient with acute renal failure caused by thrombotic microangiopathy related to antiphospholipid syndrome: case report
- Source :
- Lupus. 26:777-782
- Publication Year :
- 2016
- Publisher :
- SAGE Publications, 2016.
-
Abstract
- BackgroundMicrovascular manifestations of antiphospholipid antibody syndrome in the kidneys include acute renal failure, thrombotic microangiopathy and hypertension. Therapy has been largely empiric.Case reportA 49-year-old Chinese man presented with anuric acute renal failure without abundant proteinuria and heavy haematuria, but markedly low levels of urinary sodium, potassium and chlorine upon admission. On day 1 of hospitalization, his thrombocytopenia, anaemia and renal failure showed rapid progression. The presence of lupus anticoagulant and vascular ischaemia of the small vessels in renal arteriography were also observed. Anticoagulants, continuous renal replacement therapy, glucocorticoids and six sessions of plasma exchange were started. After the fourth plasma exchange (on day 20), his urine output increased and began to normalize. On day 25, haemodialysis was stopped and his general condition gradually improved. A renal biopsy was subsequently performed, and the histopathological diagnosis was thrombotic microangiopathy due to antiphospholipid antibody syndrome. A further 3-year follow-up showed that his haemoglobin level, platelet count and serum creatinine were within the normal range, with stable blood pressure.ConclusionTreatment modalities such as anticoagulation, immunosuppression and plasma exchange are likely to be necessary when severe acute renal failure combined with thrombotic microangiopathy present in nephropathy of antiphospholipid antibody syndrome.
- Subjects :
- Male
medicine.medical_specialty
Thrombotic microangiopathy
medicine.medical_treatment
Gastroenterology
Nephropathy
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Rheumatology
Renal Dialysis
Antiphospholipid syndrome
Internal medicine
Humans
Medicine
030212 general & internal medicine
Renal replacement therapy
Glucocorticoids
030203 arthritis & rheumatology
Lupus anticoagulant
Creatinine
Proteinuria
Plasma Exchange
medicine.diagnostic_test
Thrombotic Microangiopathies
business.industry
Anticoagulants
Acute Kidney Injury
Middle Aged
Antiphospholipid Syndrome
medicine.disease
chemistry
Lupus Coagulation Inhibitor
Disease Progression
Renal biopsy
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 14770962 and 09612033
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Lupus
- Accession number :
- edsair.doi.dedup.....52baeb10142a5f71d1e4da8037fac570