Kodali Sreenath, Ramachandran Preethi, Richard Ivan N, Wang Jen-Chin
Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, 11212 NY, USA.
Leuk Res Rep. 2019 Jul 23;12:100179. doi: 10.1016/j.lrr.2019.100179. eCollection 2019.
Sickle cell hemoglobinopathies are associated with end organ damage but very rarely present with a clinical and laboratory picture of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia, characteristic of thrombotic microangiopathy (TMA).
We present a patient with HbSC disease who developed thrombotic microangiopathy, needing both RBC exchange transfusion and therapeutic plasma exchange (TPE) for complete clinical recovery.
Although literature showed therapeutic plasma exchange alone can abrogate a similar clinical scenario, we did an in-depth review which concluded that in most of the TMA cases secondary to sickle cell disease, treatment with both with plasma exchange and red cell exchange transfusion are necessary.
镰状细胞血红蛋白病与终末器官损害相关,但极少出现微血管病性溶血性贫血(MAHA)及血小板减少的临床和实验室表现,而这是血栓性微血管病(TMA)的特征。
我们报告一名患有HbSC病的患者,其发生了血栓性微血管病,需要进行红细胞置换输血和治疗性血浆置换(TPE)才能实现完全临床康复。
尽管文献表明单独进行治疗性血浆置换可消除类似的临床情况,但我们进行了深入回顾,得出的结论是,在大多数继发于镰状细胞病的TMA病例中,血浆置换和红细胞置换输血都有必要。