Guerrero A L, Pérez-Simón J A, Cuñado A, Cacho J, Vidriales B
Sección de Neurología, Hospital Universitario, Salamanca.
An Med Interna. 1998 Oct;15(10):545-7.
We present a 41 woman who underwent an allogeneic bone marrow transplantation as a treatment for a multiple myeloma. After presenting graft-versus-host disease, hyperbilirubinemia, cyclosporine toxic levels, renal failure and peripheral schistocytosis, she developed complex partial seizures and bilateral hypodensity lesions in occipital lobes. Fulminant microangiopathy was diagnosed; though promptly treated with immunoglobulins and fenitoin, she died in few days. Necropsy showed diffuse thrombotic disease and a haematoma in left occipital lobe. We review the types of thrombotic microangiopathy described up to now, and the different pathogenic theories related to them. According to our reviewing of the literature, this is the first case of fulminant thrombotic microangiopathy ever described in Spanish language.
我们报告一位41岁女性,她接受了异基因骨髓移植以治疗多发性骨髓瘤。在出现移植物抗宿主病、高胆红素血症、环孢素中毒水平、肾衰竭和外周血裂红细胞症后,她出现了复杂部分性发作以及枕叶双侧低密度病变。诊断为暴发性微血管病;尽管立即用免疫球蛋白和苯妥英治疗,但她在数天内死亡。尸检显示弥漫性血栓形成疾病和左枕叶血肿。我们回顾了迄今为止描述的血栓性微血管病类型以及与之相关的不同致病理论。根据我们对文献的回顾,这是西班牙语中描述的首例暴发性血栓性微血管病病例。