Drug-induced de novo thrombotic microangiopathy diagnosed 2 years after renal transplantation: a case report and literature review

Table 1 Recent reports of de novo TAC-induced TMA after renal transplantation

Age	Sex	Original disease	ABO compatibility	Donor	Clinical onset		TAC trough level (ng/mL)	Clinical features		Dose adjust of TAC	Other treatment	Clinical follow-up	Outcome	References
Age	Sex	Original disease	ABO compatibility	Donor	(days)	(mos)	TAC trough level (ng/mL)	Clinical features		Dose adjust of TAC	Other treatment	Clinical follow-up	Outcome	References
56	F	CGN	Compatible	Living	4		15–20 (div.)	Systemic	Plt, Hb, Epigastralgia, Diarrhea	Reduce	PE, Transfusion, ECUM		Good	[12]
55	M	CGN	Compatible	Deceased	4		4.8	Systemic	Plt, Hb	Replace with EVR	PE, RIT		Good	[13]
31	F	Lupus nephritis	Unknown	Living	6		Unknown	Systemic	Plt, Hb, Bloody diarrhea	Discontinuation	PE	Ischemic colitis, Acute rejection	Graft loss	[4]
59	M	Diabetic nephropathy	Incompatible	Living	9		28	Systemic	Plt, Hb	Reduce	PE, DFPP, mPSL pulse therapy, RIT		Good	[14]
68	M	Unknown	Compatible	Deceased	11		11.9–27.9	Localized		Replace with SRL	None	DGF	Good	[15]
44	M	ADPKD	Compatible	Deceased	11		3.8	Localized		Discontinuation	PE, ECU	Discontinued ECU after 10 mos	Good	[16]
11	M	Renal venous thrombosis	Compatible	Deceased	12		9.9	Localized		Replace with EVR	None		Good	[17]
17	M	Unknown	Compatible	Deceased		4	8.5	Localized		Replace with SRL	None		Good	[11]
38	M	Diabetic nephropathy	Compatible	Deceased		6	Unknown	Localized		Reduce	PE	Reccurence	Good	[9]
30	F	Lupus nephritis	Compatible	Deceased		14	12	Localized		Replace with CyA	None		Graft loss	[9]
49	F	IgA nephropathy	Compatible	Living		24	5–6	Systemic	Pancytopenia, nausea, fatigue	Replace with CyA	None	No recurrence for 1 year	Good	our case

CGN Chronic glomerulonephritis, ADPKD Autosomal dominant polycystic kidney disease, EVR Everolimus, SRL Sirolimus, PE Plasma exchange, DFPP Double filtration plasmapheresis, RIT Rituximab, DGF Delayed graft function

ISSN: 2059-1381