Hemolytic Uremic Syndrome in Prostatic Carcinoma

Müller, Nicolas; Paulweber, Bernhard

doi:10.1159/000011853

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…Some afferent arterioles were occluded by thrombi, resulting in the collapse of the glomerular tufts. These vascular lesions appeared histologically similar to lesions observed in TTP/HUS, which also occur in cancer patients . Despite histological similarities, the vascular lesions in DIC differ from that of TTP/HUS.…”

Section: Discussionsupporting

confidence: 62%

“…These vascular lesions appeared histologically similar to lesions observed in TTP/HUS, which also occur in cancer patients. [16][17][18][19] Despite histological similarities, the vascular lesions in DIC differ from that of TTP/HUS. In fact, thrombi in patients with DIC are fibrin-rich, while thrombi in patients with TTP/HUS mainly consist of platelets.…”

Section: Discussionmentioning

confidence: 99%

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Morphological spectrum of renal pathology and its correlation to clinical features in patients with disseminated intravascular coagulation: A study involving a series of 21 autopsy cases

Ohashi

Ishii

Naito

et al. 2014

Pathology International

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Disseminated intravascular coagulation (DIC), a thrombohemorrhagic disorder, occurs as a secondary complication in many diseases, but the histopathological features of kidneys in DIC have not been extensively characterized thus far. We reviewed 21 autopsy cases of patients with a clinical diagnosis of DIC and studied the repertoire of renal pathology. Eighteen patients had elevated serum creatinine levels and 15 patients had a variable degree of proteinuria. Underlying disorders included malignant neoplasms in 12 patients, and abdominal aortic aneurysm, acute myocardial infarction, and systemic infections in other patients. Coexistent glomerular pathology, such as focal segmental glomerulosclerosis (FSGS) with different morphological variants, and microthrombi formation, was present in many patients. The microthrombi were histologically similar to that seen in thrombotic microangiopathy, but characteristics associated with DIC were detected by special staining. The presence of FSGS correlated with the degree of urinary protein (P = 0.0044), and the presence of acute tubular injury (ATI) and the extent of global glomerulosclerosis both correlated with serum creatinine levels (P = 0.019 and 0.0003, respectively). FSGS was probably due to endothelial cell damage, another potential etiology for FSGS. Global glomerulosclerosis, a result of previous renal injury, can be a determinant of renal function during the acute phase of DIC.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Morphological spectrum of renal pathology and its correlation to clinical features in patients with disseminated intravascular coagulation: A study involving a series of 21 autopsy cases

Ohashi

Ishii

Naito

et al. 2014

Pathology International

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“…Moreover, when HUS is induced by the administration of a drug, it generally appears several weeks or even several months after the beginning of treatment 1,2 . HUS due directly to a neoplastic disorder is rare 13,14 . An adenocarcinoma is involved in the majority of such cases, but in most cases it is actually the antimitotic agents that are at fault (mitomycin C, 5-fluorouracil, platinum-based drugs and bleomycin).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Thrombotic Microangiopathy following Radical Cystectomy for Bladder Cancer

Tauzin-Fin

Sesay

Ryman

et al. 2006

Anaesth Intensive Care

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This report describes the perioperative management of disseminated intravascular coagulation occurring abruptly during a planned cystectomy for non-metastatic bladder papillary carcinoma. Peroperatively, profuse bleeding and an acute decrease in blood pressure were effectively treated by blood transfusions and fresh frozen plasma. Haematological tests indicated the presence of disseminated intravascular coagulation. On the following three days, acute renal failure, peripheral disseminated intravascular coagulation-related thrombocytopenia and haemolytic anemia with schistocytes were suggestive of thrombotic microangiopathy. Treatment by plasma exchange along with haemodialysis was commenced. An aetiological work-up remained negative. After 21 days of treatment, haemodialysis and plasma exchange were stopped. Urological outcome was favourable. The one-year follow-up did not show any residual renal insufficiency and laboratory parameters returned to normal. In the absence of evidence in favour of an infectious, drug-related or immunological aetiology, we postulated that this thrombotic microangiopathy was caused by disseminated intravascular coagulation and that the tumour manipulation during the surgical procedure was the triggering factor.

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“…These vascular lesions are very similar to those of thrombocytopenic thrombotic purpura (TTP)/hemolytic uremic syndrome (HUS), which also occurs in prostate cancer. [16][17][18][19] Despite the histological resemblance, major difference exists in the vascular lesions between DIC and TTP/HUS. In DIC, thrombi are fibrin rich, whereas TTP/HUS presents with platelet-rich thrombi.…”

mentioning

confidence: 99%

Acute renal failure as the presenting sign of disseminated intravascular coagulation in a patient with metastatic prostate cancer

Ohashi¹,

Hosokawa²,

Kimura³

et al. 2013

IJNRD

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Disseminated intravascular coagulation (DIC) is the most frequent coagulation disorder in patients with prostate cancer. However, renal involvement in DIC associated with prostate cancer has rarely been documented. Herein, we present a case of metastatic prostate cancer presenting with acute renal failure (RF) triggered by DIC. An 80 year old man with metastatic prostate cancer was treated with antihormone therapy at an outpatient clinic. He was admitted to our hospital because of severe dyspnea and progressive RF. A hemorrhagic tendency was not clinically evident. Laboratory tests exhibited a significant coagulation disorder, suggestive of DIC. Despite treatment, his RF and dyspnea worsened, and he eventually passed away. An autopsy study revealed hypertensive nephrosclerosis superimposed by fibrin rich thrombi formation involving glomerular capillaries and arterioles characteristic of DIC. Additionally, focal segmental glomerulosclerosis was identified, which was presumably secondary to the glomerular endothelial and/or podocyte injury augmented by DIC. Those findings showed that glomerular injury, which was induced and subsequently exacerbated by DIC associated with prostate cancer, highly contributed to the progression of RF in our case. A differential diagnosis of DIC should be considered when a patient with prostate cancer presents with renal dysfunction.

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Hemolytic Uremic Syndrome in Prostatic Carcinoma

Cited by 10 publications

References 6 publications

Morphological spectrum of renal pathology and its correlation to clinical features in patients with disseminated intravascular coagulation: A study involving a series of 21 autopsy cases

Morphological spectrum of renal pathology and its correlation to clinical features in patients with disseminated intravascular coagulation: A study involving a series of 21 autopsy cases

Postoperative Thrombotic Microangiopathy following Radical Cystectomy for Bladder Cancer

Acute renal failure as the presenting sign of disseminated intravascular coagulation in a patient with metastatic prostate cancer

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