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VOLUME 20 , ISSUE 6 ( 2016 ) > List of Articles


Thrombotic microangiopathy as an initial manifestation in HIV patients

Thanigachalam Dineshkumar, Jeyachandran Dhanapriya, Palanivel Jaganathan, Ramanathan Sakthirajan, Natarajan Gopalakrishnan, T Balasubramaniyan

Keywords : Antiretroviral therapy, HIV, renal failure, thrombotic microangiopathy

Citation Information : Dineshkumar T, Dhanapriya J, Jaganathan P, Sakthirajan R, Gopalakrishnan N, Balasubramaniyan T. Thrombotic microangiopathy as an initial manifestation in HIV patients. Indian J Crit Care Med 2016; 20 (6):374-376.

DOI: 10.4103/0972-5229.183903

License: CC BY-ND 3.0

Published Online: 01-01-2014

Copyright Statement:  Copyright © 2016; The Author(s).


Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, microvascular thrombosis, and various organ dysfunctions. TMA usually occurs in a more advanced stage of HIV disease. TMA as an initial presenting feature is rare. We here report a male patient who presented with oliguric renal failure. Investigations revealed anemia, thrombocytopenia, schistocytes in peripheral smear, and HIV-positive. Renal biopsy revealed TMA. He was treated with hemodialysis and started on highly active antiretroviral therapy.

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  1. Becker S, Fusco G, Fusco J, Balu R, Gangjee S, Brennan C, et al. HIV-associated thrombotic microangiopathy in the era of highly active antiretroviral therapy: An observational study. Clin Infect Dis 2004;39 Suppl 5:S267-75.
  2. Sacristán Lista F, Saavedra Alonso AJ, Oliver Morales J, Vázquez Martul E. Nephrotic syndrome due to thrombotic microangiopathy (TMA) as the first manifestation of human immunodeficiency virus infection: Recovery before antiretroviral therapy without specific treatment against TMA. Clin Nephrol 2001;55:404-7.
  3. Boccia RV, Gelmann EP, Baker CC, Marti G, Longo DL. A hemolytic-uremic syndrome with the acquired immunodeficiency syndrome. Ann Intern Med 1984;101:716-7.
  4. de Man AM, Smulders YM, Roozendaal KJ, Frissen PH. HIV-related thrombotic thrombocytopenic purpura: Report of 2 cases and a review of the literature. Neth J Med 1997;51:103-9.
  5. Gervasoni C, Ridolfo AL, Vaccarezza M, Parravicini C, Vago L, Adorni F, et al. Thrombotic microangiopathy in patients with acquired immunodeficiency syndrome before and during the era of introduction of highly active antiretroviral therapy. Clin Infect Dis 2002;35:1534-40.
  6. Sutor GC, Schmidt RE, Albrecht H. Thrombotic microangiopathies and HIV infection: Report of two typical cases, features of HUS and TTP, and review of the literature. Infection 1999;27:12-5.
  7. del Arco A, Martinez MA, Peña JM, Gamallo C, González JJ, Barbado FJ, et al. Thrombotic thrombocytopenic purpura associated with human immunodeficiency virus infection: Demonstration of p24 antigen in endothelial cells. Clin Infect Dis 1993;17:360-3.
  8. Uthman IW, Gharavi AE. Viral infections and antiphospholipid antibodies. Semin Arthritis Rheum 2002;31:256-63.
  9. Collins T, Read MA, Neish AS, Whitley MZ, Thanos D, Maniatis T. Transcriptional regulation of endothelial cell adhesion molecules: NF-kappa B and cytokine-inducible enhancers. FASEB J 1995;9:899-909.
  10. Ruggenenti P, Remuzzi G. The pathophysiology and management of thrombotic thrombocytopenic purpura. Eur J Haematol 1996;56:191-207.
  11. Hymes KB, Karpatkin S. Human immunodeficiency virus infection and thrombotic microangiopathy. Semin Hematol 1997;34:117-25.
  12. Peraldi MN, Maslo C, Akposso K, Mougenot B, Rondeau E, Sraer JD. Acute renal failure in the course of HIV infection: A single-institution retrospective study of ninety-two patients and sixty renal biopsies. Nephrol Dial Transplant 1999;14:1578-85.
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