Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Two Unusual Cases of Thrombotic Microangiopathies

Version 1 : Received: 15 May 2024 / Approved: 15 May 2024 / Online: 15 May 2024 (11:38:58 CEST)

How to cite: Wang, S. S. Y.; Gallardo, C.; Tang, H.; Lim, E. K. G.; Christopher, D.; Fan, B. E.; Ponnudurai, K. Two Unusual Cases of Thrombotic Microangiopathies. Preprints 2024, 2024051033. https://doi.org/10.20944/preprints202405.1033.v1 Wang, S. S. Y.; Gallardo, C.; Tang, H.; Lim, E. K. G.; Christopher, D.; Fan, B. E.; Ponnudurai, K. Two Unusual Cases of Thrombotic Microangiopathies. Preprints 2024, 2024051033. https://doi.org/10.20944/preprints202405.1033.v1

Abstract

Thrombotic microangiopathies (TMA) can be attributed to a wide variety of causes and the diagnostic process is often challenging, especially when the clinical scenario is full of other confounding factors. Hemolysis can be due to complement-mediated thrombotic microangiopathies and drug-induced hemolytic anemia in the appropriate clinical context. In this case presentation, two patients with TMA including a patient diagnosed with complement-mediated TMA after a through screen of other differential diagnoses, and a multiple myeloma patient on chemotherapy with primaquine-induced hemolytic anemia in the background of treatment for possible pneumocystis jirovecii pneumonia. A thorough review of the drug history of patients presenting with TMA should be conducted, along with a heightened index of suspicion for complement-mediated disorders such as complement-mediated TMA, which should be entertained after ruling out a wide variety of differential diagnoses.

Keywords

hemolytic anemia; complement; thrombotic microangiopathy; primaquine

Subject

Medicine and Pharmacology, Hematology

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