A rare case of colic thrombotic microangiopathy in renal transplantation.
BACKGROUND
We report a case of thrombotic microangiopathy (TM) in patient with UC and kidney transplantation.


METHODS
A 59-year-old Caucasian may with a renal transplant, with atrial fibrillation and ulcerative colitis (UC), was referred for asthenia, fever (38 degrees C), anemia, colicky pain, and bloody diarrhea. The maintenance therapy consisted of CSA, sodium mycophenolate, steroids, ticlopidine, and mesalazine. Laboratory data, colonscopy, and colic mucosal biopsy revealed de novo colic TM. We administered antibiotics and antishock therapy, reducing CSA, withdrawing ticlopedine and maintaining mesalazine with the resolution of the problem.


CONCLUSIONS
Posttransplantation TM is an uncommon but severe complication of kidney transplantation associated with reduced graft survival and a high risk for death. Only an early, accurate diagnosis with optimal treatment permits resolution of the problem.
Kidney Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via Vetoio, 67100 L'Aquila, Italy. vinicio1979@interfree.it
V
V
Rizza
G
G
Coletti
C
C
Mazzotta
K
K
Clemente
P
P
Di Cocco
F
F
Del Reno
G
G
Margiotta
A
A
Famulari
F
F
Pisani
D000038:Abscess / Q000473:pathology; D000740:Anemia / Q000209:etiology; D001158:Arteries / Q000473:pathology; D001663:Bilirubin / Q000097:blood; D003093:Colitis, Ulcerative / Q000473:pathology; D006098:Granulocytes / Q000473:pathology; D006801:Humans; D007501:Iron / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D057049:Thrombotic Microangiopathies / Q000209:etiology* / Q000473:pathology; D014184:Transplantation, Homologous
D007501:Iron; D001663:Bilirubin