Plasma exchange for thrombotic microangiopathy secondary to dermatomyositis associated with acute kidney injury and complement activation: A case report with literature review

Norifumi Hayashi, Keiichirou Okada, Yuko Tsuruyama, Yu Kagaya, Sho Kumano, Yuki Ishikura, Kiminobu Takeda, Masayuki Nanbu, Keiji Fujimoto, Hiroki Adachi, Hitoshi Yokoyama

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Thrombotic microangiopathy (TMA) in patients with connective tissue disease is rare but life-Threatening. In particular, the survival rate of patients with dermatomyositis (DM) that develop TMA is low. The effectiveness of plasma exchange (PEX) therapy is unclear for the treatment of TMA secondary to DM. Case presentation: We describe a case of a 28-year-old woman who developed severe DM complicated by aspiration pneumonia from dysphagia and acute kidney injury. The patient was unresponsive to corticosteroids and intravenous immunoglobulin (IVIG) therapy and developed TMA. In this case, immunofluorescence of skin biopsy revealed that complement activation was involved in the pathogenesis of DM. After 6 PEX therapies, thrombocytopenia improved. She was successfully treated by intensive care and PEX therapy. Conclusions: PEX therapy was effective to treat TMA secondary to DM associated with complement activation.

Original languageEnglish
Article number48
JournalRenal Replacement Therapy
Volume5
Issue number1
DOIs
Publication statusPublished - 05-12-2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology
  • Transplantation

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