Published online May 4, 2017. doi: 10.5492/wjccm.v6.i2.135
Peer-review started: January 19, 2017
First decision: March 8, 2017
Revised: March 23, 2017
Accepted: April 6, 2017
Article in press: April 8, 2017
Published online: May 4, 2017
Thrombotic microangiopathies (TMA) are microvascular occlusive disorders characterized by platelet aggregation and mechanical damage to erythrocytes, clinically characterized by microangiopatic haemolytic anemia, thrombocytopenia and organ injury. We are reporting a case of a woman patient with severe hemolytic uremic syndrome associated to infectious diarrhoea caused by Shiga toxin-producing pathogen, who were admitted to our intensive care unit. The patient described developed as organ injury, neurological failure and acute renal failure, with need of haemodialysis technique. Due to the severity of the case and the delay in the results of the additional test that help us to the final diagnose, we treated her based on a syndromic approach of TMA with plasma exchange, with favourable clinical evolution with complete recovery of organ failures. We focus on the syndromic approach of these diseases, because thrombotic thrombocytopenic purpura, one of the disorders that are included in the syndromes of TMA, is considered a haematological urgency given their high mortality without treatment; and also review the TMA in adults: Their pathogenesis, management and outcomes.
Core tip: This case report of an adult patient with thrombotic microangiopathy associated to infectious diarrhoea caused by Shiga toxin-producing pathogen, shows the syndromic approach of thrombotic microangiopathies in adults, with a review of pathogenesis and management of this diseases.