Crescentic glomerulonephritis associated with thrombotic microangiopathy

A 71-year-old woman was examined at the department of urology in our hospital, with the chief complaint of macrohematuria. She was diagnosed as having bladder cancer and was hospitalized. After three courses of chemotherapy with cisplatin and epirubicin hydrochloride, total bladder resection and ileostomy were performed. Although the operation was curative, the hematuria persisted. Her renal function rapidly deteriorated. Hemolytic anemia and thrombocytopenia were found, and schistocytes were detected in a peripheral blood smear. Seizures occurred in the patient's clinical course. A diagnosis of thrombotic microangiopathy (TMA) was made. The patient died despite receiving treatment. An autopsy was performed, and the renal microscopic findings showed crescentic glomerulonephritis (Cres GN). We present a rare case of Cres GN associated with TMA. Received: December 13, 2000 / Accepted: October 31, 2001