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In evaluating a patient with thrombotic microangiopathy (TMA), it is necessary to rule out thrombotic thrombocytopenic purpura before a diagnosis of atypical hemolytic uremic syndrome (aHUS) is made. There have been reports that mutations of complement factors can coexist with partial A Disintegrin and Metalloproteinase with a ThromboSpondin type 1 motif, member 13 deficiency. Here, we report the case of a 6-year-old girl who was initially diagnosed as nephrotic syndrome and developed TMA after five years of onset of illness. She had poor response to treatment and had multiple relapses due to associated complement factor mutation. Hence, genetic evaluation has to be considered in all children presenting with aHUS.
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http://dx.doi.org/10.4103/1319-2442.261349 | DOI Listing |
Eur J Case Rep Intern Med
August 2025
Nephrology Department, Unidade Local de Saúde de Braga, Braga, Portugal.
Introduction: Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF) and is widely used in oncology for its anti-angiogenic properties. However, VEGF inhibition may result in significant nephrotoxicity, including thrombotic microangiopathy (TMA). While systemic TMA is well-described, isolated renal-limited TMA remains under recognised.
View Article and Find Full Text PDFTurk J Pediatr
September 2025
Department of Pediatric Hematology and Oncology, Batman Training and Research Hospital, Batman, Türkiye.
Background: Brucellosis is a zoonotic infection transmitted to humans by ingestion of contaminated unpasteurized dairy products or via direct or indirect contact with infected animals. It is characterized by nonspecific symptoms like fever and joint pain, and laboratory findings including anemia, leukopenia, thrombocytopenia, or rarely pancytopenia. Here we report a case of brucellosis with thrombocytopenia that did not improve despite anti-brucella treatment and required intravenous immunoglobulin treatment.
View Article and Find Full Text PDFHematology
December 2025
Adult Hematology, Transplantation and Cellular Therapy Section, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Objectives: To describe a rare case of transplantation-mediated alloimmune thrombocytopenia (TMAT) following liver transplantation from a donor with immune thrombocytopenia (ITP), and to contextualize findings within the literature.
Methods: We reviewed the clinical course of a 63-year-old man with hepatitis C cirrhosis and hepatocellular carcinoma who underwent orthotopic liver transplantation from a donor with severe thrombocytopenia consistent with ITP. Clinical, laboratory, and bone marrow findings were analyzed, and alternative causes of thrombocytopenia were excluded.
Medicine (Baltimore)
September 2025
Department of Pathophysiology, American University of Antigua, Osbourn, Antigua and Barbuda.
Rationale: Idiopathic thrombocytopenic purpura (ITP) is a hematological disorder characterized by a decrease in platelet count due to increased destruction or decreased production. Although the pathophysiology and etiology remain largely unknown, understanding the typical and atypical presentations of ITP is crucial for early diagnosis and effective management. This case report highlights the rationale behind a comprehensive approach for the diagnosis and treatment of ITP, especially in cases with atypical presentations.
View Article and Find Full Text PDFJ Hematop
September 2025
All India Institute of Medical Sciences, New Delhi, India.
This study evaluated immune cell subset variations in immune thrombocytopenia (ITP) by comparing frequencies at diagnosis with controls and assessing changes post-therapy. A single-center prospective observational study enrolled 25 untreated acute and chronic ITP patients and 20 matched controls from January 2018 to January 2019. Immune cell subsets, including CD4+, CD8+, NK cells, NK-T cells, and T regulatory cells (Tregs), were analyzed using flow cytometric immunophenotyping.
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