Tacrolimus
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Thrombotic microangiopathy: case report A 54-year-old woman developed thrombotic microangiopathy (TMA) during immunosuppressive treatment with tacrolimus. The woman with advanced decompansated liver disease, had undergone living donor liver transplantation. After liver transplantation, she developed pancytopenia which did not resolve with thrombocyte replacement and blood transfusion. Peripheral blood smear revealed widespread schistocytes and haemochromatosis consistent with haemolysis. The corrected reticulocyte count was at the upper limit (1.96%). Bone marrow aspiration showed an increase in erythroid mass without infiltration. A disintegrin and metalloproteinase with a thrombospondin type-1 motif, member 13 (ADAMTS-13) activity was detected. It was reported that, she had been receiving immunosuppressive treatment with tacrolimus [route and dosage not stated]. Based on these findings, she was diagnosed with TMA associated with tacrolimus [duration of treatment to reaction onset not stated]. The woman’s treatment with tacrolimus was discontinued, and she started receiving methylprednisolone. Thereafter, she was treated with plasmapheresis. After two weeks of treatment, her platelet count was 27000. Therefore, applied for the use of Eculizumab to the Ministry of Health [outcome not stated]. Gencdal G, et al. Transplant associated thrombotic microangiopathy after liver transplantation: A case report. Turkish Journal of Gastroenterology 30 (Suppl. 1): S53-S54 (plus 803507298 poster) abstr. P-028, Apr 2019. Available from: URL: http://doi.org/10.5152/tjg.2019.34 [abstract]
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Reactions 17 Oct 2020 No. 1826
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