A Fatal Case of Neuroblastoma Complicated by Posterior Reversible Encephalopathy with Rapidly Evolving Transplantation-Associated Thrombotic Microangiopathy
Abstract
:1. Introduction
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | CTN 2005 [9] | IWG 2007 [8] | Cho et al. [7] | Jodele et al. [3] |
---|---|---|---|---|
Schistocytes | ≥2/HPF | >4% | ≥2/HPF | Present |
Serum LDH | Elevated | Sudden or persistent elevation | Elevated | Elevated |
Renal and/or neurological dysfunction | Serum creatinine 2 × baseline or 50% dec’d creatinine clearance | NA | NA | Proteinuria ≥30 mg/dL or hypertension |
Direct and indirect Coombs test | Negative | NA | Negative | NA |
Thrombocytopenia | NA | De novo prolonged or progressive | De novo prolonged or progressive | De novo |
Anemia | NA | Decreased Hb or increased transfusion requirements | Decreased Hb | Decreased Hb or increased transfusion requirements |
Serum haptoglobin | NA | Decreased | Decreased | NA |
Terminal complement activation | NA | NA | NA | Present |
Test (Reference Range) | Day 1 | Day 5 | Day 7 | Day 8 |
---|---|---|---|---|
Leukocytes (4200–18,500/mm3) | 8540 | 8190 | 12,900 | 11,220 |
Hemoglobin (11.2–14.2 g/dL) | 14.5 | 9.7 | 11.7 | 8.5*1 |
Platelets (180,000–550,000/mm3) | 145,000 | 74,000 | 65,000 | 80,000*2 |
CRP (0.00–0.01 mg/dL) | 7.10 | 3.47 | 2.98 | 3.77 |
AST (24–41 IU/L) | 33 | 24 | 32 | 45 |
ALT (9–28 IU/L) | 32 | 15 | 15 | 16 |
Creatinine (0.22–0.43 mg/dL) | 0.32 | 0.38 | 0.25 | 0.38 |
LDH (185–350 IU/L) | 288 | 304 | 509 | 1383 |
Haptoglobin | NA | NA | NA | <10 |
Peripheral schistocytes | - | - | - | + |
Direct Coombs test | NA | NA | NA | Negative |
CH50 (25–48/mL) | NA | NA | NA | 40 |
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Matsui, M.; Makimoto, A.; Saito, Y.; Enokizono, M.; Matsuoka, K.; Yuza, Y. A Fatal Case of Neuroblastoma Complicated by Posterior Reversible Encephalopathy with Rapidly Evolving Transplantation-Associated Thrombotic Microangiopathy. Children 2023, 10, 506. https://doi.org/10.3390/children10030506
Matsui M, Makimoto A, Saito Y, Enokizono M, Matsuoka K, Yuza Y. A Fatal Case of Neuroblastoma Complicated by Posterior Reversible Encephalopathy with Rapidly Evolving Transplantation-Associated Thrombotic Microangiopathy. Children. 2023; 10(3):506. https://doi.org/10.3390/children10030506
Chicago/Turabian StyleMatsui, Motohiro, Atsushi Makimoto, Yuya Saito, Mikako Enokizono, Kentaro Matsuoka, and Yuki Yuza. 2023. "A Fatal Case of Neuroblastoma Complicated by Posterior Reversible Encephalopathy with Rapidly Evolving Transplantation-Associated Thrombotic Microangiopathy" Children 10, no. 3: 506. https://doi.org/10.3390/children10030506