Renal and pulmonary thrombotic microangiopathy triggered by proteasome-inhibitor therapy in patient with smoldering myeloma: A renal biopsy and autopsy case report

Rationale: Thrombotic microangiopathy (TMA) is a group of clinical syndromes characterized by excessive platelet activation and endothelial injury that leads to acute or chronic microvascular obliteration by intimal mucoid and fibrous thickening, with or without associated thrombi. It frequently involves the kidney but may involve any organ or system at variable frequencies depending on the underlying etiology. Among its numerous causes, drug toxicities and complement regulation abnormalities stand out as some of the most common. A more recently described association is with monoclonal gammopathy. Lung involvement by TMA is infrequent, but has been described in Cobalamin C deficiency and post stem-cell transplantation TMA. Patient concerns: This is the case of a patient with smoldering myeloma who received proteasome-inhibitor therapy due to retinopathy and developed acute renal failure within one week of therapy initiation. Diagnoses: A renal biopsy showed thrombotic microangiopathy. At the time, mild pulmonary hypertension was also noted and presumed to be idiopathic. Interventions: Given the known association of proteasome-inhibitor therapy with thrombotic microangiopathy, Bortezomib was discontinued and dialysis was initiated. Outcomes: Drug withdrawal failed to prevent disease progression and development of end-stage renal disease, as well as severe pulmonary hypertension that eventually lead to the patient's death. Lessons: To our knowledge, this is the...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Related Links:

Publication date: Available online 18 January 2020Source: The American Journal of SurgeryAuthor(s): Asishana A. Osho, Muath M. Bishawi, Elbert E. Heng, Ejiro Orubu, Aaron Amardey-Wellington, Mauricio A. Villavicencio, Masaki FunamotoAbstractBackgroundFailure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation.MethodsUsing the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Authors: Lin WC, Tsai JP, Lai YH, Lin YL, Kuo CH, Wang CH, Hsu BG Abstract Osteoprotegerin (OPG) is a potential biomarker of cardiovascular disease complications and severity. Peripheral arterial disease (PAD) is associated with an increased risk of death in patients on peritoneal dialysis (PD). Therefore, this study aimed to evaluate the relationship between serum OPG levels and PAD by measuring the ankle-brachial index (ABI) of patients on PD. A commercial enzyme-linked immunosorbent assay kit was used to measure OPG values. Left or right ABI values of
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Authors: Jun SH, Shin WK, Kim Y Abstract BACKGROUND: Soybean food consumption has been considered as a possible way to lower incidence of cardiometabolic syndrome (CMS) among Asians. However, results from studies investigating its efficacy on CMS in Asians have been inconsistent. METHODS: We analyzed the association between soybean intake frequency and prevalence of CMS based on data from the Korea National Health and Nutrition Examination Survey 2007 to 2011. Data of 9,287 women aged 20 to 64 years were analyzed. Food frequency questionnaire was used to assess soybean food consumption frequency. General linear...
Source: Diabetes and Metabolism Journal - Category: Endocrinology Tags: Diabetes Metab J Source Type: research
Authors: Lee YK, Hwangbo Y, Lee S, Lee DE, Lee EK, Yeom MS, Joo J, Kong SY Abstract Background While aspirin use is known to be associated with reduced incidence of various cancer types, it is unclear if this benefit extends to thyroid cancer. We aimed to evaluate the association between aspirin use and thyroid cancer development. Methods This nested case-control study used nationwide data from the Korean National Health Insurance Service-National Sample Cohort 2002-2015. In total, 4,547 individuals with newly developed thyroid cancer were matched with 13,641 controls based on age, sex, and follow-up period. Odds r...
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
Conclusions: Overall, we propose that the four hub genes may be potential targets in trastuzumab-resistant gastric cancer and that ISGs may play a key role in promoting trastuzumab resistance in GC. PMID: 31949544 [PubMed - in process]
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Conclusion: Combined CVVHDF with plasmapheresis is an effective treatment for patients diagnosed with germanium poisoning and associated multiple organ dysfunctions. PMID: 31951756 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
This study provides strong evidence that following a healthy lifestyle can substantially extend the years a person lives disease-free." Commentary on Recent Evidence for Cognitive Decline to Precede Amyloid Aggregation in Alzheimer's Disease https://www.fightaging.org/archives/2020/01/commentary-on-recent-evidence-for-cognitive-decline-to-precede-amyloid-aggregation-in-alzheimers-disease/ I can't say that I think the data presented in the research noted here merits quite the degree of the attention that it has been given in the popular science press. It is interesting, but not compelling if its role...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusion: The presence of clinically significant TR is associated with an increase in healthcare utilization and expenditures, irrespective of the presence of HF. PMID: 31952454 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Publication date: Available online 18 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Michael Mazzeffi, Sari D. Holmes, Diane Alejo, Clifford E. Fonner, Mehrdad Ghorieshi, Chetan Pasrija, Stefano Schena, Thomas Metkus, Rawn Salenger, Glenn Whitman, Niv Ad, Robert S.D. Higgins, Bradley Taylor, Maryland Cardiac Surgery Quality Initiative (MCSQI)AbstractBackgroundRacial disparities persist in healthcare. Our study objective was to evaluate racial disparity in cardiac surgery in Maryland.MethodsPatients were identified using a statewide database. Demographics, comorbidities, and predicted risk of mortality were co...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Authors: Alexandru S, Ortiz Arduan A, López Picasso M, García-Puente Suarez L, Pampa Saíco SE, Pizarro Sánchez MS, Cannata Ortiz P, Barba Martin R PMID: 31948826 [PubMed - as supplied by publisher]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
More News: Dialysis | Hypertension | Internal Medicine | Kidney Transplant | Kidney Transplantation | Lessons | Lung Transplant | Myeloma | Pulmonary Hypertension | Renal Failure | Stem Cell Therapy | Stem Cells | Toxicology | Transplants | Urology & Nephrology | Velcade