title: Thrombotic microangiopathy: an atypical cause of acute renal failure in patients with acute pancreatitis.
abstract: OBJECTIVE
  To report on the development and treatment of thrombotic microangiopathy, an atypical cause of acute renal failure in patients with acute pancreatitis.
  
  
  METHODS
  Case reports.
  
  
  METHODS
  A 21-bed medical intensive care unit at an university hospital.
  
  
  METHODS
  Two men with acute pancreatitis presented with acute renal failure, neurological manifestations, haemolytic anaemia and thrombocytopenia. Both patients required intensive care.
  
  
  METHODS
  Fragmented red cell count; levels of haptoglobin, amylase and lipase; serological testing for Escherichia Coli O157; computed tomography of the abdomen.
  
  
  RESULTS
  The patients' courses were rapidly favourable after daily plasma exchange. A review of the existing medical literature was also undertaken.
  
  
  CONCLUSIONS
  As thrombotic microangiopathy may be life-threatening without administration of fresh frozen plasma or plasma exchange, physicians should consider this disease as a possible cause of acute renal failure in patients with acute pancreatitis.
authors.affiliation: Service de Réanimation Médicale, Hôpital Charles Nicolle, Centre Hospitalier Universitaire de Rouen, 1 rue de Germont, 76031 Rouen, France. alexandre.boyer@chu-bordeaux.fr
authors.forename: Alexandre
authors.initials: A
authors.lastname: Boyer
authors.forename: Karim
authors.initials: K
authors.lastname: Chadda
authors.forename: Amar
authors.initials: A
authors.lastname: Salah
authors.forename: Guy
authors.initials: G
authors.lastname: Bonmarchand
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy; D000208:Acute Disease; D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000139:chemically induced / Q000150:complications*; D019512:Pancreatitis, Alcoholic / Q000150:complications; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000209:etiology* / Q000628:therapy; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects; D018119:Stavudine / Q000009:adverse effects
chemical_list: D018894:Reverse Transcriptase Inhibitors; D018119:Stavudine