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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 (Fernández García) 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 del pulmó 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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