An Atypical Case of Thrombotic Microangiopathy Secondary to Acute Pancreatitis

Abstract

Thrombotic microangiopathies (TMAs) are a group of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage. It can often be challenging to determine the underlying etiology. Our patient presented with acute pancreatitis and later developed thrombocytopenia and hemolytic anemia, along with acute renal failure. A working diagnosis of an atypical hemolytic uremic syndrome was made; however, he improved clinically and eculizumab was not started. Workup for the atypical hemolytic uremic syndrome was unrevealing. The authors propose that the pancreatitis triggered a secondary TMA, which although rare, has previously been described in the literature. This case illustrates the diagnostic and therapeutic challenges associated with TMAs.