Transplantation-associated thrombotic microangiopathy isolated to a congenital anomaly of the lung

Rebecca T Kummen; Geoffrey D E Cuvelier; Camelia Stefanovici; Anamarija M Perry; Rick Higgins; Rochelle Yanofsky; Suyin A Lum Min; Donna A Wall

doi:10.1111/petr.12824

Transplantation-associated thrombotic microangiopathy isolated to a congenital anomaly of the lung

Pediatr Transplant. 2017 Feb;21(1). doi: 10.1111/petr.12824. Epub 2016 Nov 24.

Authors

Rebecca T Kummen¹, Geoffrey D E Cuvelier^{1

2}, Camelia Stefanovici³, Anamarija M Perry³, Rick Higgins⁴, Rochelle Yanofsky¹, Suyin A Lum Min⁵, Donna A Wall^{1

2

6}

Affiliations

¹ Section of Pediatric Hematology/Oncology, Department of Pediatrics and Child Health, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba, Canada.
² Manitoba Blood and Marrow Transplant Program, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
³ Department of Pathology, University of Manitoba and Diagnostic Services of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada.
⁴ Department of Radiology, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba, Canada.
⁵ Department of Surgery, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba, Canada.
⁶ Department of Internal Medicine, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba, Canada.

PMID: 27882637
DOI: 10.1111/petr.12824

Abstract

TA-TMA is a post-hematopoietic stem cell transplant complication with clinical features of hemolytic anemia and thrombocytopenia. A 26-month-old child who had had an allogeneic transplant for treatment of DBA developed severe TA-TMA with heavy red blood cell and platelet transfusion dependence. Incidentally, he was found to have a lung sequestration. TA-TMA resolved and transfusion dependence resolved after resection of the sequestration. The finding suggests the malformation vasculature was selectively vulnerable to the trigger of TA-TMA-raising perhaps a clue to basic pathophysiology of TA-TMA and/or vascular malformations.

Keywords: allogeneic stem cell transplantation; anemia; child; graft-vs-host disease; lung diseases; pediatric hematopoietic stem cell.

Publication types

Case Reports

MeSH terms

Child, Preschool
Erythrocyte Transfusion
Erythrocytes
Graft vs Host Disease / etiology*
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Lung / abnormalities*
Lung Diseases / congenital*
Male
Platelet Transfusion
Thrombotic Microangiopathies / etiology*
Transplantation, Homologous
Treatment Outcome