Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Thrombotic Microangiopathy due to Malignant Hypertension Following Corticosteroid Therapy for Microscopic Polyangitis
Katsunobu Yoshioka, Taeka Hattori, Yoshihiro Isaka, Toshimasa Yamaguchi, Keiko Yamagami, Takashi Morikawa, Yoshio Konishi, Toshihiko Sato, Masahito Imanishi
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Keywords: Thrombotic microangiopathy, Malignant hypertension, Corticosteroid
JOURNAL OPEN ACCESS

2007 Volume 46 Issue 11 Pages 785-788

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Abstract

A 78-year-old woman was treated with 40 mg of prednisolone for microscopic polyangitis, and favorable effects were observed. However, her blood pressure increased and she developed severe thrombocytopenia. Thrombotic microangiopathy (TMA) due to malignant hypertension was suspected and she was treated with an angiotensin-converting enzyme inhibitor; her platelet count then rose. She showed a close temporal relationship between initiation of corticosteroid therapy and the onset of TMA. Corticosteroid therapy should be used with caution in patients with underlying vascular endothelial damage.

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© 2007 by The Japanese Society of Internal Medicine
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