Postsurgical thrombotic microangiopathy : Case series and review of the literature
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
OBJECTIVES: Describe the clinical presentation, treatment, and outcomes of postsurgical thrombotic microangiopathy (TMA).
METHODS: In this retrospective study, records of individuals diagnosed with TMA developing within 30 days of a surgical procedure at Mayo Clinic from 2000 to 2016 were reviewed. Available literature regarding postsurgical TMA was comparatively reviewed.
RESULTS: Twenty patients were diagnosed with TMA developing within 30 (median 6.5, range (1-28)) days) following a procedure. Preceding procedures included orthopedic (n = 4), vascular (n = 4), abdominal (n = 8), thoracic (n = 2), and other (n = 2). Review of the literature identified 65 patients with postsurgical TMA and cardiovascular procedures were the most common preceding surgery. The majority of patients in the current cohort and literature were treated with therapeutic plasma exchange (TPE). Among the evaluable patients in the current cohort, 100% demonstrated response to TPE; however, 25% required the addition of other therapy including eculizumab to maintain a response 80% of patients in the literature demonstrated a response to TPE.
CONCLUSIONS: Although rare, early recognition and treatment of postsurgical TMA can lead to good outcomes. More research is necessary to determine the underlying pathophysiology and optimal treatment for postsurgical TMA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:103 |
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| Enthalten in: |
European journal of haematology - 103(2019), 4 vom: 27. Okt., Seite 307-318 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sridharan, Meera [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers |
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| Anmerkungen: |
Date Completed 11.02.2020 Date Revised 11.02.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ejh.13284 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298653206 |
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| 500 | |a Date Revised 11.02.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVES: Describe the clinical presentation, treatment, and outcomes of postsurgical thrombotic microangiopathy (TMA) | ||
| 520 | |a METHODS: In this retrospective study, records of individuals diagnosed with TMA developing within 30 days of a surgical procedure at Mayo Clinic from 2000 to 2016 were reviewed. Available literature regarding postsurgical TMA was comparatively reviewed | ||
| 520 | |a RESULTS: Twenty patients were diagnosed with TMA developing within 30 (median 6.5, range (1-28)) days) following a procedure. Preceding procedures included orthopedic (n = 4), vascular (n = 4), abdominal (n = 8), thoracic (n = 2), and other (n = 2). Review of the literature identified 65 patients with postsurgical TMA and cardiovascular procedures were the most common preceding surgery. The majority of patients in the current cohort and literature were treated with therapeutic plasma exchange (TPE). Among the evaluable patients in the current cohort, 100% demonstrated response to TPE; however, 25% required the addition of other therapy including eculizumab to maintain a response 80% of patients in the literature demonstrated a response to TPE | ||
| 520 | |a CONCLUSIONS: Although rare, early recognition and treatment of postsurgical TMA can lead to good outcomes. More research is necessary to determine the underlying pathophysiology and optimal treatment for postsurgical TMA | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a eculizumab | |
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| 650 | 4 | |a thrombocytopenia | |
| 650 | 4 | |a thrombotic thrombocytopenic purpura | |
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| 700 | 1 | |a Winters, Jeffrey L |e verfasserin |4 aut | |
| 700 | 1 | |a Go, Ronald S |e verfasserin |4 aut | |
| 700 | 0 | |a Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy Disease-Oriented Group |e verfasserin |4 aut | |
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