title: Thrombotic microangiopathy due to malignant hypertension following corticosteroid therapy for microscopic polyangitis.
abstract: A 78-year-old woman was treated with 40 mg of prednisolone for microscopic polyangitis, and favorable effects were observed. However, her blood pressure increased and she developed severe thrombocytopenia. Thrombotic microangiopathy (TMA) due to malignant hypertension was suspected and she was treated with an angiotensin-converting enzyme inhibitor; her platelet count then rose. She showed a close temporal relationship between initiation of corticosteroid therapy and the onset of TMA. Corticosteroid therapy should be used with caution in patients with underlying vascular endothelial damage.
authors.affiliation: Internal Medicine, Osaka City General Hospital, Osaka. kmyoshi@rr.iij4u.or.jp
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Taeka
authors.initials: T
authors.lastname: Hattori
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Isaka
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamagami
authors.forename: Takashi
authors.initials: T
authors.lastname: Morikawa
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Konishi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.forename: Masahito
authors.initials: M
authors.lastname: Imanishi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000175:diagnosis / Q000209:etiology; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology*; D014657:Vasculitis / Q000188:drug therapy / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones; D011239:Prednisolone