title: Thrombotic microangiopathy presenting with a considerable accumulation of ascites: a case report.
abstract: A 46-year-old man presented with fever, thrombocytopenia, and a considerable accumulation of ascites. Although prednisolone and intravenous cyclophosphamide pulse (IVCY) were effective, he experienced recurrence. Renal insufficiency and hemolytic anemia developed subsequently. Schistocytes, negative Coombs' test, and elevated lactate dehydrogenase levels indicated thrombotic microangiopathy (TMA). He recovered well after receiving plasma infusion, IVCY, and prednisolone. Renal biopsy revealed subendothelial widening, thereby confirming TMA. This is a very rare case of TMA that presented with a considerable volume of ascites.
authors.affiliation: Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shirai
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ishii
authors.forename: Ryu
authors.initials: R
authors.lastname: Watanabe
authors.forename: Yumi
authors.initials: Y
authors.lastname: Tajima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujii
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Takasawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Hideo
authors.initials: H
authors.lastname: Harigae
mesh_terms: D001201:Ascites / Q000150:complications*; D001379:Azathioprine / Q000627:therapeutic use; D001803:Blood Transfusion; D003520:Cyclophosphamide / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011239:Prednisolone / Q000627:therapeutic use; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D012008:Recurrence; D057049:Thrombotic Microangiopathies / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D001379:Azathioprine