Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis
While most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic micr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Hematology Reports |
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| Online Access: | https://www.mdpi.com/2038-8330/15/1/2 |
| _version_ | 1797611450525548544 |
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| author | Youssef Bouferraa Yolla Haibe Hanan Hamdan Rami Mahfouz Zaher Chakhachiro Ali Shamseddine |
| author_facet | Youssef Bouferraa Yolla Haibe Hanan Hamdan Rami Mahfouz Zaher Chakhachiro Ali Shamseddine |
| author_sort | Youssef Bouferraa |
| collection | DOAJ |
| description | While most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic microangiopathy in a 61-year-old male patient with a treatment-refractory metastatic colorectal cancer invading his bone marrow. Plasmapheresis does not constitute the mainstay of treatment in this setting, as targeting the primary disease is the ultimate management. Treating the condition of our patient has been challenging as multiple lines of treatments of his primary disease had been exhausted. The discrepancy in KRAs status obtained between PCR and later NGS offered a new treatment line with Cetuximab. In this article, we will discuss the different factors that differentiate between idiopathic and cancer-induced microangiopathy. We will emphasize on the fact that the treatment of the primary disease constitutes the most important step in the treatment of cancer-induced thrombotic microangiopathy. We will also raise several explanations to target the disagreement in KRAS status obtained by the different technical modalities. |
| first_indexed | 2024-03-11T06:29:00Z |
| format | Article |
| id | doaj.art-58c8ddac83f2408ca2a150e860e27bd3 |
| institution | Directory Open Access Journal |
| issn | 2038-8330 |
| language | English |
| last_indexed | 2024-03-11T06:29:00Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj.art-58c8ddac83f2408ca2a150e860e27bd32023-11-17T11:22:26ZengMDPI AGHematology Reports2038-83302023-01-0115191610.3390/hematolrep15010002Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad PrognosisYoussef Bouferraa0Yolla Haibe1Hanan Hamdan2Rami Mahfouz3Zaher Chakhachiro4Ali Shamseddine5Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut 1107 2020, LebanonWhile most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic microangiopathy in a 61-year-old male patient with a treatment-refractory metastatic colorectal cancer invading his bone marrow. Plasmapheresis does not constitute the mainstay of treatment in this setting, as targeting the primary disease is the ultimate management. Treating the condition of our patient has been challenging as multiple lines of treatments of his primary disease had been exhausted. The discrepancy in KRAs status obtained between PCR and later NGS offered a new treatment line with Cetuximab. In this article, we will discuss the different factors that differentiate between idiopathic and cancer-induced microangiopathy. We will emphasize on the fact that the treatment of the primary disease constitutes the most important step in the treatment of cancer-induced thrombotic microangiopathy. We will also raise several explanations to target the disagreement in KRAS status obtained by the different technical modalities.https://www.mdpi.com/2038-8330/15/1/2thrombotic thrombocytopenic purpuraplasmapheresiscolorectal canceranemiathrombocytopenia |
| spellingShingle | Youssef Bouferraa Yolla Haibe Hanan Hamdan Rami Mahfouz Zaher Chakhachiro Ali Shamseddine Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis Hematology Reports thrombotic thrombocytopenic purpura plasmapheresis colorectal cancer anemia thrombocytopenia |
| title | Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis |
| title_full | Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis |
| title_fullStr | Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis |
| title_full_unstemmed | Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis |
| title_short | Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis |
| title_sort | thrombotic microangiopathy in the setting of colorectal cancer a therapeutic challenge with a bad prognosis |
| topic | thrombotic thrombocytopenic purpura plasmapheresis colorectal cancer anemia thrombocytopenia |
| url | https://www.mdpi.com/2038-8330/15/1/2 |
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