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Thrombotic microangiopathy: an atypical cause of acute renal failure in patients with acute pancreatitis

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Abstract

Objective

To report on the development and treatment of thrombotic microangiopathy, an atypical cause of acute renal failure in patients with acute pancreatitis.

Design

Case reports.

Setting

A 21-bed medical intensive care unit at an university hospital.

Patients

Two men with acute pancreatitis presented with acute renal failure, neurological manifestations, haemolytic anaemia and thrombocytopenia. Both patients required intensive care.

Measurements

Fragmented red cell count; levels of haptoglobin, amylase and lipase; serological testing for Escherichia Coli O157; computed tomography of the abdomen.

Main results

The patients’ courses were rapidly favourable after daily plasma exchange. A review of the existing medical literature was also undertaken.

Conclusion

As thrombotic microangiopathy may be life-threatening without administration of fresh frozen plasma or plasma exchange, physicians should consider this disease as a possible cause of acute renal failure in patients with acute pancreatitis.

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Acknowledgements

The authors thank Philippe Jouvet (Institute Pasteur, Paris) for performing VTEC serological testing, and Richard Medeiros, Rouen University Hospital Medical Editor, for his valuable editorial assistance.

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Author notes

  1. Alexandre Boyer

    Present address: Département de Réanimation Médicale, Hôpital Pellegrin-Tripode, 1 place Amélie Raba-Léon, 33076, Bordeaux Cedex, France

Authors and Affiliations

  1. Service de Réanimation Médicale, Hôpital Charles Nicolle, Centre Hospitalier Universitaire de Rouen, 1 rue de Germont, 76031, Rouen, France

    Alexandre Boyer, Karim Chadda, Amar Salah & Guy Bonmarchand

Authors
  1. Alexandre Boyer
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  2. Karim Chadda
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  3. Amar Salah
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  4. Guy Bonmarchand
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Corresponding author

Correspondence to Alexandre Boyer.

Additional information

The authors were supported by a grant from SmithKline Beecham (France)

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Boyer, A., Chadda, K., Salah, A. et al. Thrombotic microangiopathy: an atypical cause of acute renal failure in patients with acute pancreatitis. Intensive Care Med 30, 1235–1239 (2004). https://doi.org/10.1007/s00134-004-2272-y

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  • DOI: https://doi.org/10.1007/s00134-004-2272-y

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