Thrombotic microangiopathy on kidney biopsy in a patient with TAFRO syndrome

CEN Case Reports
Toshikazu OzekiShoichi Maruyama

Abstract

TAFRO syndrome represents a characteristic constellation of symptoms comprising Thrombocytopenia, Anasarca, myeloFibrosis, Renal dysfunction, and Organomegaly, and is considered to be a clinicopathologic variant of idiopathic multicentric Castleman disease. A 51-year-old woman was admitted to the hospital complaining of abdominal distension. Findings on physical examination were indicative of anasarca. Computed tomography revealed mild splenomegaly, pericardial effusion, pleural effusion, ascites, and paraaortic lymphadenopathy. Blood tests showed thrombocytopenia, and urinalysis demonstrated hematuria, proteinuria, and worsening renal function. Kidney biopsy was performed and revealed thrombotic microangiopathy-like lesions with global sclerosis of 1 of the 16 glomeruli on light microscopy. The remaining glomeruli had a distinct lobular pattern, with mesangiolysis, double contours of the glomerular basement membranes, and marked endothelial swelling. Immunofluorescence studies for IgG, IgM, IgA, C1q, C3, C4, κ-light chains, and λ-light chains were indeterminate. Electron microscopy showed marked endothelial swelling. We made a diagnosis of TAFRO syndrome and started steroid treatment, following which her symptoms gradually imp...Continue Reading

References

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Feb 12, 2017·BMC Nephrology·Anubha MutnejaYing Maggie Chen

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Citations

May 12, 2019·CEN Case Reports·Hirotaka SaitoJunichiro James Kazama
Sep 24, 2018·CEN Case Reports·Keiko HashimotoNorihiro Nakata
Oct 19, 2019·BMC Nephrology·Yoshikuni NagayamaKatsuyuki Matsui
Nov 25, 2020·BMJ Case Reports·Julie SemenchukVishal Kukreti
Jan 29, 2021·Tzu Chi Medical Journal·Ya-Ju Wu, Kuei-Ying Su
May 1, 2021·International Journal of Hematology·Hiroshi KawabataYasufumi Masaki

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