Thrombotic microangiopathy

Authors

  • Clara García Enríquez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Daniel Artiles Martínez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Tamara Riverol Díaz Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Luis Alberto Santos Pérez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Yisel González Rios Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Daniel Cabrera Hernández Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Elizabeth Díaz Mederos Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba
  • Dianelí Lorely Reyes Hernández Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Keywords:

thrombotic microangiopathy, microangiopatic hemolytic anaemia

Abstract

A female patient of 26 years old, with personal pathological history of congenital glaucoma and blindness in the right eye that three days before his admission to “Arnaldo Milian Castro” Hospital began with chills, fever of 39-410°C, universal headache, nausea, projectile vomiting and fetid dark urine, fot those reasons she was admitted in the “Celestino Hernández Robau” Hospital with the presumptive diagnosis of dengue; she evolved bad, so she was sent to “Arnaldo Milian Castro” Hospital with the same symptoms and taking consciousness. On physical examination of the central nervous system, It was appreciated nuchal rigidity ++, bilateral Babinsky, somnolence, disorientation and Glasgow 13/15. An axial computerized tomography was realized that showed hypodense of both thalamuses badly definite, in the midline of both cerebellar hemispheres an image of similar characteristics and III ventricle collapsed. It raised vasculitis with multiple several cerebral infarctions and possible meningoencephalitis and died 26 days admitted. Pathologic findings allowed the diagnosis of damage and multiple organ failure in patient suffering thrombotic microangiopathy.

Downloads

Download data is not yet available.

Author Biographies

Clara García Enríquez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Especialista de II Grado en Anatomía Patológica. Profesora Auxiliar de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Daniel Artiles Martínez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado en Anatomía Patológica. Profesor Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Tamara Riverol Díaz, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado en Medicina General Integral. Residente de Anatomía Patológica.

Luis Alberto Santos Pérez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado en Medicina Interna. Especialista de II Grado en Medicina Intensiva y Emergencia. Máster en Medicina Intensiva y en Infectología Clínica. Profesor Auxiliar de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Yisel González Rios, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Residente de Imagenología

Daniel Cabrera Hernández, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Residente de Hematología

Elizabeth Díaz Mederos, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Residente de Nefrología

Dianelí Lorely Reyes Hernández, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado en Medicina Interna. Profesora Instructora de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

References

1. Moschcowitz E. An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries. Arch Intern Med. 1925;36:89-93.

2. De la Rubia J, Contreras E, Del Río-Garma J. Púrpura trombocitopénica trombótica. Med Clin (Barc). 2011. doi:10.1016/j.medcli.2010.02.011

3. Salazar Morales Miguel F, Reyes Castro María M. Púrpura trombocitopénica trombótica. Informe de un caso y revisión de la fisiopatología. Revista de la Facultad de Medicina de la UNAM. Vol. 56, N.o 1. Enero-Febrero 2013.

4. Sadler JE. Von Willebrand, ADAMTS13, and thrombotic thrombocytopenic purpura. Blood. 2008; 112(1):11-8.

5. Fujimura Y, Matsumoto M, Yagi H. Thrombotic Microangiopathy. Rinsho Shinkeigaku. 2006;46(11):902-5.

6. Allford SL, Machin SJ. Current understanding of the pathophysiology of thrombotic thrombocytopenic purpura. J Clin Pathol. 2000;53:497-501.

7. Manea M, Karpman D. Molecular basis of ADAMTS13 dysfunction in thrombotic thrombocytopenic purpura. Pediatr Nephrol. 2009;24:447-58.

8. Zheng XL, Sadler JE. Pathogenesis of thrombotic microangiopathies. Annu Rev Pathol. 2008;3:249-77.

9. Banno F, Miyata T. Biology of an Antithrombotic Factor-ADAMTS13. In: Tanaka K, Davie EW. Recent Advances in Thrombosis and Hemostasis. Springer; 2008. Pp 162-176.

10. Halevy D, Radhakrishnan J, Markowitz G, et al. Thrombotic microangiopathies. Crit Care Clin. 2002);18:309-20.

11. Reig Mezquida Juan P. Solé Jover Amparo, et al. Microangiopatía trombótica asociada a tacrolimus en trasplante pulmonary. Arch Bronconeumol. 2015;51(5):e23-e24. Disponible en: http://www.archbronconeumo.org.

12. Taleb A, Ayatollah S, Hamid M, et al. Thrombotic Thrombocytopenic Purpura associated with Clopidogrel: a case report and review of the literature. J Res Med Sci. 2011;16(3): 353-7.

Published

2016-07-01

How to Cite

1.
García Enríquez C, Artiles Martínez D, Riverol Díaz T, Santos Pérez LA, González Rios Y, Cabrera Hernández D, et al. Thrombotic microangiopathy. Acta Méd Centro [Internet]. 2016 Jul. 1 [cited 2025 Jun. 27];10(3):91-108. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/693

Issue

Section

Clinicopathological Sessions