Is thrombotic microangiopathy a paraneoplastic phenomenon? Case report and review of the literature

Abstract

It is currently recognized that the pathogenesis of malignancy-associated thrombotic microangiopathy (TMA) is distinct from thrombotic thrombocytopenic purpura. This carries important implications in its classification and its management. Here, we report a case of occult malignancy presenting initially as acute kidney injury secondary to TMA and highlight the importance of considering an underlying malignancy in patients not responding to conventional therapy for TMA.

Post-partum occurrence of Wunderlich syndrome and microangiopathic haemolytic anaemia (MAHA): a case report

“…RCC is more commonly associated with erythrocytosis and thrombocytosis. However, malignancy related TTP has been reported in several adenocarcinomas, most commonly of breast, lung, and stomach [ 12 ]. Although it’s exact pathophysiology is not known, most cases of malignancy related TMA have a normal ADAMTS 13 activity.…”

“…Another mechanism is that there is red cell fragmentation from direct contact of erythrocytes with tumour emboli. However, both these theories are more suitable in metastatic cancer [ 12 , 13 ].…”