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Martinelli AW, Dunn W, McClure ME, Walker I, Stewart A, Karia S, Preston SD, Thiru S, Torpey N, Ojha S, Symington E, Nathan JA. A Case of Thrombotic Microangiopathy and Acute Sarcoidosis. Chest 2022; 162:e245-e248. [PMID: 36344132 PMCID: PMC9752182 DOI: 10.1016/j.chest.2022.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 11/06/2022] Open
Abstract
Although sarcoidosis is an established cause of multiorgan dysfunction, acute presentation with thrombotic microangiopathy resulting in severe renal and hematological sequelae has not been reported. We describe the case of a patient presenting with hypercalcemia, pancreatitis, and acute renal failure, followed by microangiopathic hemolytic anemia. Although there were no significant respiratory symptoms, thoracic radiology and mediastinal lymph node biopsy results were in keeping with sarcoidosis as the underlying cause of this multisystem presentation. Corticosteroids were commenced with clinical and biochemical improvement. This novel case highlights the need to consider sarcoidosis as part of the differential diagnosis for unusual multiorgan presentations and for early multidisciplinary involvement in such cases to permit optimal treatment.
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Affiliation(s)
- Anthony W. Martinelli
- Department of Respiratory Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, England,Cambridge Institute of Therapeutic Immunology and Infectious Disease, Department of Medicine, University of Cambridge, Cambridge, England,CORRESPONDENCE TO: Anthony Martinelli, MB, BChir
| | - William Dunn
- Department of Haematology, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Mark E. McClure
- Department of Renal Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Ieuan Walker
- Department of Haematology, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Andrew Stewart
- Department of Renal Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Sumit Karia
- Department of Radiology, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Stephen D. Preston
- Department of Histopathology, Royal Papworth Hospital, Cambridge, England
| | - Sathia Thiru
- Department of Histopathology, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Nicholas Torpey
- Department of Renal Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Sanjay Ojha
- Department of Renal Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - Emily Symington
- Department of Haematology, Addenbrooke’s Hospital, Hills Road, Cambridge, England
| | - James A. Nathan
- Department of Respiratory Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, England,Cambridge Institute of Therapeutic Immunology and Infectious Disease, Department of Medicine, University of Cambridge, Cambridge, England
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