Ormonde Carolina, Querido Sara, Rombo Nuno, Roque Rita, Clemente Belarmino, Weigert André
Nephrology Department, Hospital do Divino Espírito Santo, Portugal.
Nephrology Department, Centro Hospitalar Lisboa Ocidental-Hospital Santa Cruz, Portugal.
Case Rep Transplant. 2021 Nov 15;2021:9261371. doi: 10.1155/2021/9261371. eCollection 2021.
Thrombotic microangiopathy (TMA) is a rare disease that presents with haemolysis and organ damage. The kidney is one of the main affected organs, and TMA is associated with serious complications and increased mortality. In transplanted patients, TMA is even less common and has a variety of possible causes, including thrombotic thrombocytopenic purpura (TTP) and haemolytic-uremic syndrome (HUS), infections, drugs, autoimmune disease, tumours, and malignant hypertension. Transplant-related causes, such as antibody-mediated rejection, calcineurin inhibitors, and viral infections, need to be considered as well. The authors report a rare case of TMA in a kidney transplant recipient, whose investigation revealed malignant hypertension secondary to primary hyperaldosteronism.
血栓性微血管病（TMA）是一种罕见疾病，表现为溶血和器官损害。肾脏是主要受累器官之一，TMA与严重并发症及死亡率增加相关。在移植患者中，TMA更为少见，有多种可能病因，包括血栓性血小板减少性紫癜（TTP）和溶血尿毒综合征（HUS）、感染、药物、自身免疫性疾病、肿瘤及恶性高血压。还需考虑与移植相关的病因，如抗体介导的排斥反应、钙调神经磷酸酶抑制剂及病毒感染。作者报告了1例肾移植受者发生TMA的罕见病例，其检查发现原发性醛固酮增多症继发恶性高血压。
