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TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report

A 57-year-old man who received a kidney transplant 4 years previously owing to unknown underlying disease presented with thrombocytopenia and fever. Hepatosplenomegaly and lymphadenopathy were observed, and development of prominent anasarca and worsening of renal function yielded the diagnosis of TA...

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Autores principales: Nagai, Marie, Uchida, Takahiro, Yamada, Muneharu, Komatsu, Shuuhei, Ota, Kohei, Mukae, Mitsuya, Iwamoto, Hitoshi, Hirano, Hiroshi, Karube, Miho, Kaname, Shinya, Oda, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520974/
https://www.ncbi.nlm.nih.gov/pubmed/34671626
http://dx.doi.org/10.3389/fmed.2021.747678
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author Nagai, Marie
Uchida, Takahiro
Yamada, Muneharu
Komatsu, Shuuhei
Ota, Kohei
Mukae, Mitsuya
Iwamoto, Hitoshi
Hirano, Hiroshi
Karube, Miho
Kaname, Shinya
Oda, Takashi
author_facet Nagai, Marie
Uchida, Takahiro
Yamada, Muneharu
Komatsu, Shuuhei
Ota, Kohei
Mukae, Mitsuya
Iwamoto, Hitoshi
Hirano, Hiroshi
Karube, Miho
Kaname, Shinya
Oda, Takashi
author_sort Nagai, Marie
collection PubMed
description A 57-year-old man who received a kidney transplant 4 years previously owing to unknown underlying disease presented with thrombocytopenia and fever. Hepatosplenomegaly and lymphadenopathy were observed, and development of prominent anasarca and worsening of renal function yielded the diagnosis of TAFRO syndrome. He was treated with high-dose steroids and plasmapheresis, and a thrombopoietin receptor agonist was administered for refractory thrombocytopenia. However, his general condition worsened, and he died on day 92. Histopathological analysis of a kidney autopsy specimen showed thrombotic microangiopathy characterized by glomerular endothelial swelling, mesangiolysis, and double contours of the glomerular capillary walls. His bone marrow showed megakaryocytic hyperplasia with mild reticulin fibrosis. Interestingly, these clinical and pathological features were remarkably similar to those the patient demonstrated before the kidney transplant, suggesting the recurrence of TAFRO syndrome. TAFRO syndrome is a rare systemic disorder whose concept has recently been established, but information on its long-term outcome is scarce. To our knowledge, this is the first case of TAFRO syndrome developing in a kidney transplant recipient, which suggests that disease recurrence occurs many years after the kidney transplant.
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spelling pubmed-85209742021-10-19 TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report Nagai, Marie Uchida, Takahiro Yamada, Muneharu Komatsu, Shuuhei Ota, Kohei Mukae, Mitsuya Iwamoto, Hitoshi Hirano, Hiroshi Karube, Miho Kaname, Shinya Oda, Takashi Front Med (Lausanne) Medicine A 57-year-old man who received a kidney transplant 4 years previously owing to unknown underlying disease presented with thrombocytopenia and fever. Hepatosplenomegaly and lymphadenopathy were observed, and development of prominent anasarca and worsening of renal function yielded the diagnosis of TAFRO syndrome. He was treated with high-dose steroids and plasmapheresis, and a thrombopoietin receptor agonist was administered for refractory thrombocytopenia. However, his general condition worsened, and he died on day 92. Histopathological analysis of a kidney autopsy specimen showed thrombotic microangiopathy characterized by glomerular endothelial swelling, mesangiolysis, and double contours of the glomerular capillary walls. His bone marrow showed megakaryocytic hyperplasia with mild reticulin fibrosis. Interestingly, these clinical and pathological features were remarkably similar to those the patient demonstrated before the kidney transplant, suggesting the recurrence of TAFRO syndrome. TAFRO syndrome is a rare systemic disorder whose concept has recently been established, but information on its long-term outcome is scarce. To our knowledge, this is the first case of TAFRO syndrome developing in a kidney transplant recipient, which suggests that disease recurrence occurs many years after the kidney transplant. Frontiers Media S.A. 2021-10-04 /pmc/articles/PMC8520974/ /pubmed/34671626 http://dx.doi.org/10.3389/fmed.2021.747678 Text en Copyright © 2021 Nagai, Uchida, Yamada, Komatsu, Ota, Mukae, Iwamoto, Hirano, Karube, Kaname and Oda. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Nagai, Marie
Uchida, Takahiro
Yamada, Muneharu
Komatsu, Shuuhei
Ota, Kohei
Mukae, Mitsuya
Iwamoto, Hitoshi
Hirano, Hiroshi
Karube, Miho
Kaname, Shinya
Oda, Takashi
TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report
title TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report
title_full TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report
title_fullStr TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report
title_full_unstemmed TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report
title_short TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report
title_sort tafro syndrome in a kidney transplant recipient that was diagnosed on autopsy: a case report
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520974/
https://www.ncbi.nlm.nih.gov/pubmed/34671626
http://dx.doi.org/10.3389/fmed.2021.747678
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