[Extensive bone marrow necrosis and thrombotic microangiopathic anemia revealing disseminated adenocarcinoma].
BACKGROUND
Bone marrow necrosis and thrombotic microangiopathy are uncommonly associated. We report an observation.


METHODS
A 52-year-old man with extensive bone marrow necrosis, associated with hemolytic microangiopathic anemia, was treated unsuccessfully with corticosteroids and plasmapheresis. Outcome was fatal. Autopsy showed disseminated bone marrow necrosis and medullary invasion by adenocarcinoma cells in this patient operated 13 years earlier for gastric cancer.


CONCLUSIONS
Extensive bone marrow necrosis or thrombotic microangiopathy can complicate usually advanced cancer. Prognosis is poor without response to chemotherapy. Corticosteroids and plasma exchange are sometimes successful. A relative efficacy of treatment with staphylococcal protein A immunopheresis is reported by several authors in thrombotic microangiopathy.
Service de Rhumatologie, Hôtel-Dieu, CHU de Nantes.
P
P
Chevalet
A
A
Moreau
F
F
Muller
J M
JM
Berthelot
M
M
Hamidou
A
A
Prost
D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000743:Anemia, Hemolytic / Q000209:etiology* / Q000628:therapy; D001344:Autopsy; D001853:Bone Marrow / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009361:Neoplasm Invasiveness; D010956:Plasmapheresis; D012008:Recurrence
D000305:Adrenal Cortex Hormones
Nécrose médullaire extensive et anémie microangiopathique thrombotique révélant un adénocarcinome disséminé.