M HASBAHÇECİ, F BAŞAK, T CANBAK, G BAS, O ALİMOĞLU

Thrombotic microangiopathy following acute pancreatitis

Akut pankreatitin, trombotik mikroanjiyopatinin akut atağının potansiyel tetikleyicisi olması nadir bir durumdur. Tekrarlayan akut biliyer atakları olan 22 yaşındaki kadın hasta hospitalize edildi. Akut pankreatitin takip eden üç günlük gerileme dönemi sonrasında konfüzyon, anemi, trombositopeni, serum laktat dehidrogenaz seviyesinde artış ve akut böbrek yetmezliği gelişti. Bu bulgularla trombotik mikroanjiyopati tanısı konuldu. Devamlı hemofiltrasyon, taze donmuş plazma transfüzyonu ve intravenöz prednizolon tedavisi başlandı. Hasta sorunsuz bir şekilde taburcu edildi. Akut böbrek yetmezliği dâhil trombotik mikroanjiyopatinin biyolojik ve klinik bulguları olan akut pankreatit olgularında, trombotik mikroanjiyopatiden şüphelenilmelidir. Plazma temelli tedavilerin erken başlanmasının, prognoz ve uzun dönemli renal fonksiyonlar üzerinde olumlu etkisi vardır.

Akut pankreatit sonrası trombotik mikroanjiyopati

Acute pancreatitis as a potential triggering event for an acute episode of thrombotic microangiopathy and is a rare phenomenon. A 22-year-old female patient was hospitalized with a diagnosis of recurrent acute biliary pancreatitis. Confusion, anemia, thrombocytopenia, an increase in serum lactate dehydrogenase and acute renal failure developed within the next three days. With these findings, thrombotic microangiopathy was diagnosed. Continuous hemodiafiltration and fresh frozen plasma transfusions with intravenous methylprednisolone were applied. There was a full recovery. Acute pancreatitis should be suspected when there are other biological and clinical signs of thrombotic microangiopathy including acute renal failure. Early institution of plasma based therapies will improve prognosis and long term renal function

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