Small intestinal thrombotic microangiopathy following kidney transplantation diagnosed by balloon-assisted enteroscopy

 
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Annals of Gastroenterology
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Τμήμα περιοδικού (EL)
Επιστημονικό άρθρο (EL)
2021 (EL)
Small intestinal thrombotic microangiopathy following kidney transplantation diagnosed by balloon-assisted enteroscopy (EN)
Makazu, Makomo
Teranishi, Jun-ichi
Kobayashi, Ryosuke
Ozeki, Yuichiro
Ikeda, Ryosuke
Sato, Chiko
Nishio, Masafumi
Maeda, Koki
Maeda, Shin
Inayama, Yoshiaki
Hirasawa, Kingo
Fukuchi, Takehide
Sawada, Atsushi
Thrombotic microangiopathy (TMA) is a serious complication following kidney transplantation. Although intestinal TMA is a major organ injury and causes abdominal pain, diarrhea and bloody stools, the clinical and endoscopic characteristics of small intestinal TMA remain unclear. Here, we report a drug-induced small intestinal TMA, which did not meet the laboratory-defined TMA criteria but was diagnosed by balloon-assisted enteroscopy (BAE). A 32-year-old woman who underwent kidney transplantation at the age of 10 years complained of abdominal pain, diarrhea and bloody stools one month after starting everolimus (EVE) as an immunosuppressant. Although she did not meet the diagnostic criteria for TMA serologically, BAE revealed a circumferential ulcer in the jejunum, and the pathological findings of a biopsy specimen showed microvascular thrombi, compatible with intestinal TMA. Her symptoms improved upon the discontinuation of EVE, demonstrating that EVE can cause drug-induced intestinal TMA. The present case suggests that BAE should be performed when abdominal pain, diarrhea, and bloody stools occur in patients receiving immunosuppressive medication following kidney transplantation, even if there is no evidence of TMA according to the laboratory definition. Keywords Thrombotic microangiopathy, balloon-assisted enteroscopy, kidney transplantation, everolimus, small intestine Ann Gastroenterol 2021; 34 (1): 119-121 (EN)
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Case Report
Αγγλική γλώσσα
2021-01-04
http://www.annalsgastro.gr/index.php/annalsgastro/article/view/5535
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 34, No 1 (2021); 119 (EN)
Copyright (c) 2021 Annals of Gastroenterology (EN)



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