Disseminated histoplasmosis presenting as thrombotic microangiopathy

Denis M. Dwyre, Adam M. Bell, Kathleen Siechen, Sanjeev Sethi, Thomas J. Raife

Research output: Contribution to journalArticle

15 Scopus citations

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 immunosuppression, 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.

Original languageEnglish (US)
Pages (from-to)1221-1225
Number of pages5
JournalTransfusion
Volume46
Issue number7
DOIs
StatePublished - Jul 1 2006

    Fingerprint

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

Cite this