A case of TMA developed during treatment for SLE.
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- Kawanishi Ayana
- Department of Pediatrics, Hamamatsu University School of Medicine
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- Yasuoka Ryuhei
- Department of Pediatrics, Hamamatsu University School of Medicine
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- Koda Masaki
- Department of Pediatrics, Hamamatsu University School of Medicine
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- Katoh Yukiko
- Department of Pediatrics, Hamamatsu University School of Medicine
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- Uchida Hiroshi
- Department of Pediatrics, Hamamatsu University School of Medicine
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- Kitagata Ryoichi
- Department of Pediatrics, Hamamatsu University School of Medicine
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- Natsume Osamu
- Department of Pediatrics, Hamamatsu University School of Medicine
Bibliographic Information
- Other Title
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- 全身性エリテマトーデスの治療中に発症した血栓性微小血管症の女児例
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Abstract
<p>Thrombotic microangiopathy (TMA) is a serious complication of systemic lupus erythematosus (SLE) that reportedly occurs in parallel with increased SLE disease activity. We report the case of a girl who developed TMA soon after the onset and treatment of SLE, despite improvement in SLEDAI (SLE disease activity index) and serological markers. The 12-year-old girl had developed SLE with severe lupus nephritis. After the initial round of steroid pulse therapy, her platelet count increased and her anti-ds-DNA antibody titer decreased. However, her hemoglobin level and platelet count declined after the second round of steroid pulse therapy (day 12 of hospitalization), and even schistocytes were observed in a peripheral blood smear. Those suggested the development of TMA. On day 16, we commenced plasma exchange therapy and initiated treatment with intravenous cyclophosphamide and oral mycophenolate mofetil; on day 33, the schistocytosis resolved. Because TMA can develop at any time during the course of SLE treatment, clinicians should consider TMA as a possible complication in SLE patients who develop schistocytosis or experience any unusual changes in SLE disease activity.</p>
Journal
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- The Journal of Clinical Pediatric Rheumatology
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The Journal of Clinical Pediatric Rheumatology 13 (1), 48-53, 2022-12-28
Pediatric Rheumatology Association of Japan
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Keywords
Details 詳細情報について
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- CRID
- 1390295104416736384
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- ISSN
- 2434608X
- 24351105
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- Text Lang
- ja
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- Data Source
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- JaLC
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- Abstract License Flag
- Disallowed