Thrombotic microangiopathy: an atypical cause of acute renal failure in patients with acute pancreatitis.
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.
Boyer
Alexandre
A
Service de Réanimation Médicale, Hôpital Charles Nicolle, Centre Hospitalier Universitaire de Rouen, 1 rue de Germont, 76031 Rouen, France. alexandre.boyer@chu-bordeaux.fr
Chadda
Karim
K
Salah
Amar
A
Bonmarchand
Guy
G
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
D018894:Reverse Transcriptase Inhibitors; D018119:Stavudine