Monday, February 1, 2010
The etiology is anything that can be damaging to the endothelium ( Calcineurins, other chemotherapy agents, total body radiation, GVHD or the primary cancer returning back with a TMA component)
The presentation may involve the kidney as the primary site. The acute TMA kidney biopsy will resemble that of pre eclampsia with or without mesangiolysis and intraglomerular and renal arteriloar thrombi and double contouring as well if there is chronic TMA ( MPGN pattern of injury).
Risk factors for TMA post transplant include female race, cytoxan high dose induction, TBI without shielding and CNI and sirolimus use.
Many people consider chronic TMA in post BMT patients a radiation nephropathy and TBI as the major risk factor and the damaging the endothelium. Does pheresis help in this instance? Less likely as its more of a direct insult on the endothelium and not really an antibody mediated that can be removed with pheresis.
Left image courtesy: Kidney International
- ► 2020 (32)
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- CLINICAL CASE 5
- Luminex Technology
- IN THE NEWS ---> CLASSIFICATION FOR DIABETIC NEPH...
- Nephrectomy or No Nephrectomy?
- CONSULT ROUNDS: ORTHOSTATIC PROTEINURIA
- TOPIC DISCUSSION Risk factors for bleeding post ki...
- New drugs for Hepatitis C
- CDC HIGH RISK DONORS
- TOPIC DISCUSSION: Peritoneal Dialysis First initia...
- CLINICAL CASE 4
- Adrenal Gland Transplantation
- IN THE NEWS --->Is BMT Nephropathy really mostly ...
- Sad News
- TOPIC DISCUSSION: Tamm Horsfall Mucoprotein
- TOPIC DISCUSSION: Re-evaluating the Role of Immuno...
- JOURNAL CLUB: DNA Methylation controls Foxp3 gene ...
- In the News: The era of epigenetics
- Sirolimus and tubular toxicity
- TOPIC DISCUSSION: FIBROTIC DISEASES
- IN THE NEWS --> IgA with ANCAs
- JOURNAL CLUB: Pirfenidone Is Renoprotective in Dia...
- IN THE NEWS- CKD and Proteinuria
- CLINICAL CASE 3
- Positive Cross Match, Desensitization
- CONSULT ROUNDS: Post Bone Marrow Transplant Thromb...
- ▼ February (25)