- 著者
- Atsuhiko Suenaga Naoki Sawa Katsuyuki Miki Takayoshi Yokoyama Yasuo Ishii Hiroki Mizuno Daisuke Ikuma Yuki Oba Akinari Sekine Masayuki Yamanouchi Eiko Hasegawa Tatsuya Suwabe Kei Kono Keiichi Kinowaki Kenichi Ohashi Kazuho Honda Motoaki Miyazono Yuki Nakamura Yoshifumi Ubara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.0813-22, (Released:2023-02-01)
- 参考文献数
- 16
We experienced a 36-year-old man with lupus nephritis and antiphospholipid syndrome (APS) who received a donor kidney from his father. Twenty-two months after transplantation, at a time of poor adherence to immunosuppressants and warfarin, the patient developed sudden graft loss due to hemolytic uremic syndrome with rapid deterioration of renal function, thrombocytopenia, and hemolytic anemia. A kidney biopsy showed thrombotic microangiopathy (TMA) related to platelet thrombus formation; however, there was no recurrence of lupus and no findings suggestive of post-transplant rejection, so acute TMA associated with APS was thought to be the cause of the graft loss. This case highlights the importance of instructing patients with lupus nephritis to adhere to treatment with warfarin, a therapeutic drug for APS.