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. 2021 Feb 10;8(3):002294.
doi: 10.12890/2021_002294. eCollection 2021.

Transplant-associated Thrombotic Microangiopathy Treated with Eculizumab and Romiplostim

Muhammad Awidi  1 , Meenu Jain  1 , Russell Baur  1
Affiliations

Transplant-associated Thrombotic Microangiopathy Treated with Eculizumab and Romiplostim

Muhammad Awidi et al. Eur J Case Rep Intern Med. .

Abstract

Transplant-associated thrombotic microangiopathy (TA-TMA) can occur after solid organ transplantation. It results in thrombocytopenia, haemolytic anaemia and microvascular occlusion. TA-TMA is not fully understood and treatment has not been clearly established. However, there is increasing evidence to suggest an immune-complement mediated component to its development. Eculizumab is a monoclonal antibody that inhibits the cleavage of C5 into pro-inflammatory, prothrombotic terminal complement elements and has been utilized in the treatment of atypical haemolytic uremic syndrome. We report a case of TA-TMA successfully treated with eculizumab and romiplostim. This case adds to the evidence that TA-TMA is triggered by complement dysregulation and suggests possible interventions for refractory cases.

Learning points: Transplant-associated thrombotic microangiopathy (TA-TMA) may occur in solid organ transplant patients.Eculizumab may be used for the treatment of TA-TMA.

Keywords: Eculizumab; romiplostim; transplant thrombotic microangiopathy.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

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