Abstract

Thrombotic microangiopathy (TMA) is a clinical condition resulting from severe endothelial damage and leading to microangiopathic hemolytic anemia, consumptive thrombocytopenia, and ischemia of distal organs. TMA does not only develop in the native kidney but also appears as a recurrent or de novo condition in the transplanted kidney.Etiology of de novo TMA includes renal ischemia, antibody-mediated rejection, malignancies, viral infections (CMV, parvovirus B19, BK polyomavirus, and HHV-6), antiphospholipid antibodies, anticardiolipin antibodies developing in HCV-positive patients, and medications (calcineurin inhibitors, m-TOR inhibitors, and antiviral medications).Early diagnosis and treatment of TMA can be lifesaving. In this report, we present our experiences of successful treatment of a renal transplant case of TMA due to BK virus, not a frequent cause of TMA. The clinical picture of TMA caused by endothelial damage through cytopathic effects of viral antigens was evaluated in the light of the relevant literature.

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