Clin Pediatr Hematol Oncol.  2011 Oct;18(2):161-164.

Thrombotic Microangiopathy during Ganciclovir Treatment for Cytomegalovirus Infection in a Patient with Autologous Hematopoietic Stem Cell Transplantation

Affiliations
  • 1Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea. pedpje@ajou.ac.kr
  • 2Department of Pathology, Ajou University School of Medicine, Suwon, Korea.

Abstract

Thrombotic microangiopathy (TMA) is a known complication of hematopoietic stem cell transplantation (HSCT). Here, we describe a case of TMA after autologous HSCT, which was associated with ganciclovir treatment. A 5-year-old boy presented with Coombs-negative hemolytic anemia, thrombocytopenia, gross hematuria, massive proteinuria, and hypertension during ganciclovir treatment after autologous HSCT. TMA was confirmed by renal biopsy which showed swelling of endothelial cells, occlusion of the glomerular lumina, duplication of glomerular basement membranes, and mesangiolysis. There was complete resolution of TMA in both laboratory and clinical manifestations after ganciclovir cessation only with supportive cares and hydration.

Keyword

Thrombotic microangiopathy; Cytomegalovirus; Ganciclovir

MeSH Terms

Anemia, Hemolytic
Biopsy
Cytomegalovirus
Cytomegalovirus Infections
Endothelial Cells
Ganciclovir
Glomerular Basement Membrane
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Hematuria
Humans
Hypertension
Preschool Child
Proteinuria
Thrombocytopenia
Thrombotic Microangiopathies
Ganciclovir
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