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Abhinaya Sridhar, MD
Rathnamitreyee Vegunta, MD
Russell Rozario, MD
William Assante, MD
Leanne Forman, MD
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Abhinaya Sridhar, MD
Rathnamitreyee Vegunta, MD
Russell Rozario, MD
William Assante, MD
Leanne Forman, MD
Westchester Medical Center - New York Medical College
ABSTRACT:
Thrombotic microangiopathy (TMA) is defined as the presence of microangiopathic hemolytic anemia and thrombocytopenia (MAHA-T), associated with end-organ dysfunction. We report a rare presentation of MAHA-T triggered by acute pancreatitis (AP) with normal ADAMTS13 levels and treated with therapeutic plasma exchange (TPE).
This is a rare case of a 25 year old, recently post-partum woman who was admitted with acute gallstone pancreatitis. Her hospital course was complicated by acute MAHA-T likely induced by pancreatitis in addition to her post-partum state. She was successfully treated with steroids and TPE.
MAHA-T is a rare complication of AP.The few cases of MAHA-T in the setting of AP that have been described show good outcomes with the use of TPE. Our patient was also started on TPE with resolution of thrombocytopenia and anemia. While TPE remains the mainstay of treatment, it is unclear if the observed hematologic and clinical response is related to TPE or to the improvement of underlying inflammatory response, or both. Further research is warranted.
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