Cargando…

Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis

While most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic micr...

Descripción completa

Detalles Bibliográficos
Autores principales: Bouferraa, Youssef, Haibe, Yolla, Hamdan, Hanan, Mahfouz, Rami, Chakhachiro, Zaher, Shamseddine, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844426/
https://www.ncbi.nlm.nih.gov/pubmed/36648880
http://dx.doi.org/10.3390/hematolrep15010002
_version_ 1784870655449104384
author Bouferraa, Youssef
Haibe, Yolla
Hamdan, Hanan
Mahfouz, Rami
Chakhachiro, Zaher
Shamseddine, Ali
author_facet Bouferraa, Youssef
Haibe, Yolla
Hamdan, Hanan
Mahfouz, Rami
Chakhachiro, Zaher
Shamseddine, Ali
author_sort Bouferraa, Youssef
collection PubMed
description While most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic microangiopathy in a 61-year-old male patient with a treatment-refractory metastatic colorectal cancer invading his bone marrow. Plasmapheresis does not constitute the mainstay of treatment in this setting, as targeting the primary disease is the ultimate management. Treating the condition of our patient has been challenging as multiple lines of treatments of his primary disease had been exhausted. The discrepancy in KRAs status obtained between PCR and later NGS offered a new treatment line with Cetuximab. In this article, we will discuss the different factors that differentiate between idiopathic and cancer-induced microangiopathy. We will emphasize on the fact that the treatment of the primary disease constitutes the most important step in the treatment of cancer-induced thrombotic microangiopathy. We will also raise several explanations to target the disagreement in KRAS status obtained by the different technical modalities.
format Online
Article
Text
id pubmed-9844426
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-98444262023-01-18 Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis Bouferraa, Youssef Haibe, Yolla Hamdan, Hanan Mahfouz, Rami Chakhachiro, Zaher Shamseddine, Ali Hematol Rep Case Report While most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic microangiopathy in a 61-year-old male patient with a treatment-refractory metastatic colorectal cancer invading his bone marrow. Plasmapheresis does not constitute the mainstay of treatment in this setting, as targeting the primary disease is the ultimate management. Treating the condition of our patient has been challenging as multiple lines of treatments of his primary disease had been exhausted. The discrepancy in KRAs status obtained between PCR and later NGS offered a new treatment line with Cetuximab. In this article, we will discuss the different factors that differentiate between idiopathic and cancer-induced microangiopathy. We will emphasize on the fact that the treatment of the primary disease constitutes the most important step in the treatment of cancer-induced thrombotic microangiopathy. We will also raise several explanations to target the disagreement in KRAS status obtained by the different technical modalities. MDPI 2023-01-04 /pmc/articles/PMC9844426/ /pubmed/36648880 http://dx.doi.org/10.3390/hematolrep15010002 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Bouferraa, Youssef
Haibe, Yolla
Hamdan, Hanan
Mahfouz, Rami
Chakhachiro, Zaher
Shamseddine, Ali
Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
title Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
title_full Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
title_fullStr Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
title_full_unstemmed Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
title_short Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
title_sort thrombotic microangiopathy in the setting of colorectal cancer: a therapeutic challenge with a bad prognosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844426/
https://www.ncbi.nlm.nih.gov/pubmed/36648880
http://dx.doi.org/10.3390/hematolrep15010002
work_keys_str_mv AT bouferraayoussef thromboticmicroangiopathyinthesettingofcolorectalcanceratherapeuticchallengewithabadprognosis
AT haibeyolla thromboticmicroangiopathyinthesettingofcolorectalcanceratherapeuticchallengewithabadprognosis
AT hamdanhanan thromboticmicroangiopathyinthesettingofcolorectalcanceratherapeuticchallengewithabadprognosis
AT mahfouzrami thromboticmicroangiopathyinthesettingofcolorectalcanceratherapeuticchallengewithabadprognosis
AT chakhachirozaher thromboticmicroangiopathyinthesettingofcolorectalcanceratherapeuticchallengewithabadprognosis
AT shamseddineali thromboticmicroangiopathyinthesettingofcolorectalcanceratherapeuticchallengewithabadprognosis