Ischemic colitis as a manifestation of thrombotic microangiopathy following bone marrow transplantation.
Thrombotic microangiopathy (TMA) is a microvascular disorder characterized by platelet aggregation and hemolytic anemia. In the setting of bone marrow transplantation (BMT), ischemic colitis due to TMA is difficult to differentiate from acute graft-versus-host disease. We report a 32-year-old man who presented ischemic colitis due to TMA after unrelated BMT for myelodysplastic syndrome. He suffered from treatment-resistant bloody diarrhea, and died of renal failure and Aspergillus pleuritis on day 253 post-BMT. Autopsy revealed endothelial injuries of arterioles and ischemic changes in the intestines and kidneys. Clinical and pathological characteristics of ischemic colitis due to BMT-associated TMA are described.
Komeno
Yukiko
Y
Department of Cell Therapy & Transplantation Medicine, University of Tokyo Hospital, Tokyo.
Ogawa
Seishi
S
Ishida
Tateru
T
Takeuchi
Kengo
K
Tsujino
Shiho
S
Kurokawa
Mineo
M
Aoki
Katsunori
K
Kanda
Yoshinobu
Y
Chiba
Shigeru
S
Motokura
Toru
T
Fukayama
Masashi
M
Hirai
Hisamaru
H
D000328:Adult; D000743:Anemia, Hemolytic / Q000150:complications* / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D017091:Colitis, Ischemic / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000175:diagnosis; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000209:etiology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008833:Microcirculation / Q000473:pathology; D013927:Thrombosis / Q000150:complications / Q000209:etiology*