Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/141165
Title: Pulmonary tumor thrombotic microangiopathy: report of 3 cases and review of the literature
Author: Gainza, Eukene
Fernández, Sara
Martínez, Daniel
Castro, Pedro
Bosch Aparici, Francisco Javier
Ramírez Ruz, J. (José)
Pereira Saavedra, Arturo
Cibeira, María Teresa
Esteve, Jordi
Nicolás, Josep M.
Keywords: Tumors
Malalties dels pulmons
Càncer de pulmó
Tumors
Pulmonary diseases
Lung cancer
Issue Date: Nov-2014
Publisher: Lippincott, Williams & Wilkins. Wolters Kluwer Health
Abstract: Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare clinical entity where tumor cell embolisms in pulmonary circulation induce thrombotic microangiopathy (TMA), respiratory failure, and subacute cor pulmonale.We describe 3 cases of PTTM that presented as the initial manifestation of metastatic gastric adenocarcinoma with TMA and pulmonary infiltrates.All 3 cases had similar clinical and laboratory features, which included moderate thrombocytopenia without renal failure, hemolysis with extremely high serum lactate dehydrogenase levels, leukoerythroblastosis in peripheral blood smear, altered coagulation tests, lymphadenopathies, and interstitial pulmonary infiltrates. All patients died within 2 weeks of diagnosis. Two cases were initially misdiagnosed as idiopathic thrombotic thrombocytopenic purpura and treated with plasma exchange with no response. One patient had bone marrow infiltration by malignant cells. Autopsies revealed PTTM associated with gastric disseminated adenocarcinoma (signet-ring cell type in 2 patients and poorly differentiated type in 1).PTTM should be considered in the differential diagnosis of patients with fulminant microangiopathic hemolytic anemia, such as atypical thrombotic thrombocytopenic purpura, mainly those with pulmonary infiltrates, disseminated intravascular coagulation, or Trousseau syndrome.
Note: Reproducció del document publicat a: https://doi.org/10.1097/MD.0000000000000219
It is part of: Medicine, 2014, vol. 93, num. 24, p. 359-363
URI: http://hdl.handle.net/2445/141165
Related resource: https://doi.org/10.1097/MD.0000000000000219
ISSN: 0025-7974
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (Fonaments Clínics)

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