Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult

A 62-year-old male who was receiving prednisolone and methotrexate for scleroderma and rheumatoid arthritis complained of diarrhea and vomiting, and was transferred to our hospital for detailed examination and treatment of renal dysfunction and thrombocytopenia. Hemolytic anemia and crushed erythroc...

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Autores principales: Ichikawa, Yumi, Murata, Masato, Aoki, Makoto, Nakajima, Jun, Isshiki, Yuta, Sawada, Yusuke, Fukushima, Kazunori, Oshima, Kiyohiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: De Gruyter 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101476/
https://www.ncbi.nlm.nih.gov/pubmed/32258416
http://dx.doi.org/10.1515/med-2020-0030
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author Ichikawa, Yumi
Murata, Masato
Aoki, Makoto
Nakajima, Jun
Isshiki, Yuta
Sawada, Yusuke
Fukushima, Kazunori
Oshima, Kiyohiro
author_facet Ichikawa, Yumi
Murata, Masato
Aoki, Makoto
Nakajima, Jun
Isshiki, Yuta
Sawada, Yusuke
Fukushima, Kazunori
Oshima, Kiyohiro
author_sort Ichikawa, Yumi
collection PubMed
description A 62-year-old male who was receiving prednisolone and methotrexate for scleroderma and rheumatoid arthritis complained of diarrhea and vomiting, and was transferred to our hospital for detailed examination and treatment of renal dysfunction and thrombocytopenia. Hemolytic anemia and crushed erythrocytes were found during the patient’s course; therefore, we suspected thrombotic microangiopathy (TMA). His ADAMTS13 activity was 60.3% and his ADAMTS13 inhibitor was under 0.5. In addition, his blood culture was positive for Streptococcus pneumoniae, and we finally diagnosed Streptococcus pneumoniae-associated TMA (pTMA). The patient was treated with antibiotics and hemodialysis. The patient recovered and was discharged on the 45(th) hospital day. Adult pTMA cases are remarkably rare. We herein report a successfully treated adult case of pTMA.
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spelling pubmed-71014762020-03-31 Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult Ichikawa, Yumi Murata, Masato Aoki, Makoto Nakajima, Jun Isshiki, Yuta Sawada, Yusuke Fukushima, Kazunori Oshima, Kiyohiro Open Med (Wars) Case Report A 62-year-old male who was receiving prednisolone and methotrexate for scleroderma and rheumatoid arthritis complained of diarrhea and vomiting, and was transferred to our hospital for detailed examination and treatment of renal dysfunction and thrombocytopenia. Hemolytic anemia and crushed erythrocytes were found during the patient’s course; therefore, we suspected thrombotic microangiopathy (TMA). His ADAMTS13 activity was 60.3% and his ADAMTS13 inhibitor was under 0.5. In addition, his blood culture was positive for Streptococcus pneumoniae, and we finally diagnosed Streptococcus pneumoniae-associated TMA (pTMA). The patient was treated with antibiotics and hemodialysis. The patient recovered and was discharged on the 45(th) hospital day. Adult pTMA cases are remarkably rare. We herein report a successfully treated adult case of pTMA. De Gruyter 2020-03-19 /pmc/articles/PMC7101476/ /pubmed/32258416 http://dx.doi.org/10.1515/med-2020-0030 Text en © 2020 Yumi Ichikawa et al., published by De Gruyter http://creativecommons.org/licenses/by/4.0 This work is licensed under the Creative Commons Attribution 4.0 Public License.
spellingShingle Case Report
Ichikawa, Yumi
Murata, Masato
Aoki, Makoto
Nakajima, Jun
Isshiki, Yuta
Sawada, Yusuke
Fukushima, Kazunori
Oshima, Kiyohiro
Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult
title Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult
title_full Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult
title_fullStr Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult
title_full_unstemmed Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult
title_short Streptococcus Pneumoniae-associated Thrombotic Microangiopathy in an Immunosuppressed Adult
title_sort streptococcus pneumoniae-associated thrombotic microangiopathy in an immunosuppressed adult
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101476/
https://www.ncbi.nlm.nih.gov/pubmed/32258416
http://dx.doi.org/10.1515/med-2020-0030
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