Thrombotic microangiopathy due to malignant hypertension following corticosteroid therapy for microscopic polyangitis

Intern Med. 2007;46(11):785-8. doi: 10.2169/internalmedicine.46.6291. Epub 2007 Jun 1.

Abstract

A 78-year-old woman was treated with 40 mg of prednisolone for microscopic polyangitis, and favorable effects were observed. However, her blood pressure increased and she developed severe thrombocytopenia. Thrombotic microangiopathy (TMA) due to malignant hypertension was suspected and she was treated with an angiotensin-converting enzyme inhibitor; her platelet count then rose. She showed a close temporal relationship between initiation of corticosteroid therapy and the onset of TMA. Corticosteroid therapy should be used with caution in patients with underlying vascular endothelial damage.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Endothelium, Vascular / physiology
  • Female
  • Humans
  • Hypertension, Malignant / chemically induced*
  • Hypertension, Malignant / complications*
  • Hypertension, Malignant / diagnosis
  • Prednisolone / adverse effects
  • Prednisolone / therapeutic use
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / etiology
  • Thrombosis / diagnosis
  • Thrombosis / etiology*
  • Vascular Diseases / diagnosis
  • Vascular Diseases / etiology*
  • Vasculitis / drug therapy
  • Vasculitis / pathology

Substances

  • Adrenal Cortex Hormones
  • Prednisolone