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Septic Shock and Thrombotic Microangiopathy Due to Mycobacterium tuberculosis in a Nonimmunocompromised Patient
Arch Intern Med. 2001;161:1347-1348.
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Report of a Case
A 69-year-old woman was admitted to our medical intensive care unit
for septic shock and multiple organ failure combined with thrombotic microangiopathy.
The patient was of Vietnamese and Malagasy ethnic origin without any recent
travel. Her medical history consisted of recurrent episodes of autoimmune
IgG–mediated hemolytic anemia with thrombocytopenia and mild acute renal
failure. At this time the results of viral serologic tests (human immunodeficiency
virus [HIV] and hepatitis B and C), immunological tests (antinuclear antibodies
and rheumatoid factor), and an electrophoresis of plasma proteins were negative.
The findings from a bone marrow aspirate were normal. No specific cause was
found, and the patient spontaneously improved.
Three weeks before hospital admission in our medical intensive care
unit, she was hospitalized in an internal medicine unit for fever, diarrhea,
abdominal pain, and cough. Laboratory findings showed microangiopathic hemolytic
anemia, thrombocytopenia, lupus anticoagulant, and a monoclonal IgM lambda
gammopathy, without hypogammaglobulinemia. The . . . [Full Text of this Article]
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