Computed tomography findings of early-stage TAFRO syndrome and associated adrenal abnormalities
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ONCOLOGY
Computed tomography findings of early-stage TAFRO syndrome and associated adrenal abnormalities Ryo Kurokawa 1 & Wataru Gonoi 1 & Hajime Yokota 2 & Saiko Isshiki 3 & Kenji Ohira 4 & Hideaki Mizuno 5 & Takao Kiguchi 6 & Shohei Inui 1,7 & Mariko Kurokawa 8,9 & Shimpei Kato 1,10 & Mitsuru Matsuki 11 & Taro Takeda 12 & Kota Yokoyama 13 & Yoshiaki Ota 14 & Yudai Nakai 1 & Eriko Maeda 1 & Harushi Mori 1 & Osamu Abe 1 Received: 13 February 2020 / Revised: 22 March 2020 / Accepted: 24 April 2020 # European Society of Radiology 2020
Abstract Objectives To compare CT findings of early (within 3 weeks post-onset)- and later (within 1 month before or after diagnostic criteria were satisfied, and later than 3 weeks post-onset) stage thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome. Methods Between 2014 and 2019, 13 patients with TAFRO syndrome (8 men and 5 women; mean age, 54.9 years) from nine hospitals were enrolled. The number of the following CT findings (CT factors) was recorded: the presence of anasarca, organomegaly, adrenal ischaemia, anterior mediastinal lesion, bony lesion, and lymphadenopathy. Records of adrenal disorders (adrenomegaly, ischaemia, and haemorrhage) throughout the disease course were also collected. Differences in CT factors at each stage were statistically compared between remission and deceased groups. Results Para-aortic oedema and mild lymphadenopathy were observed in all patients, whereas pleural effusion, ascites, and subcutaneous oedema were found in 5/13, 7/13, and 7/13 cases, respectively, at the early stage. CT factors at the early stage were significantly higher in the deceased than in the remission group (mean, 11 vs 6.5; p = 0.04), while they were nonsignificant at the later stage. Adrenal disorders were present in 7/13 cases throughout the course including 6 of adrenomegaly and 4 of ischaemia at the early stage. Conclusions Para-aortic oedema and mild lymphadenopathy are most common at the early stage. Anasarca, organomegaly, lymphadenopathy, and adrenal disorders on early-stage CT are useful for unfavourable prognosis prediction. Moreover, adrenal disorders are frequent even at the early stage and are useful for early diagnosis of TAFRO syndrome.
* Wataru Gonoi [email protected] 1
Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
2
Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-396 Kosugi-machi, Nakahara-ku, Kawasaki-shi, Kanagawa 211-8533, Japan
3
Department of Radiology, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugi-machi, Nakahara-ku, Kawasaki-shi, Kanagawa 211-8533, Japan
4
Department of Radiology, Chiba University Hospita, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan
5
Department of Hematology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
6
Department of Diagnostic Radiology, Ichinomiya N
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