Rare Case of Congenital Thrombotic Thrombocytopenic Purpura Presenting as Posttransplant Thrombotic Microangiopathy

Middle-aged female underwent transplantation with her mother as a donor after appropriate desensitization. The patient developed graft dysfunction with systemic features of thrombotic microangiopathy. Renal allograft biopsy was suggestive of antibody-mediated rejection. She was treated with plasmaph...

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Bibliographic Details
Main Authors: Akila Viswanathan, Vidyashankar Panchangam, Shashank Shetty, Govardhan Reddy, Sanjeev S. Tonshal, Prakash Doraiswamy, M. R. Shashank, Kiran Krishne Gowda, Parameswaran Anoop
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Indian Journal of Transplantation
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Online Access:https://journals.lww.com/10.4103/ijot.ijot_29_24
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Summary:Middle-aged female underwent transplantation with her mother as a donor after appropriate desensitization. The patient developed graft dysfunction with systemic features of thrombotic microangiopathy. Renal allograft biopsy was suggestive of antibody-mediated rejection. She was treated with plasmapheresis followed by intravenous immunoglobulin. However, due to lack of response, further workup was sent and the patient was found to have ADAMTS 13 levels <1% with no evidence of antibodies. Hence, she was diagnosed to have congenital thrombotic thrombocytopenic purpura. A graft nephrectomy was done, and the patient was managed with frozen plasma infusions until remission. Currently, the patient is back on maintenance hemodialysis and is doing well and planned for a genetic study.
ISSN:2212-0017
2212-0025