{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:50:15Z","timestamp":1793994615626,"version":"4.8.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T00:00:00Z","timestamp":1148428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:p><jats:bold>BACKGROUND:\u2002<\/jats:bold>Thrombotic microangiopathies (TMA) are systemic vasoocclusive disorders associated with significant morbidity and mortality. Rapid and reliable diagnosis of TMA is critical. The diagnosis is complicated by a lack of objective and sensitive laboratory testing as well as multiple concurrent diseases, including infectious processes.<\/jats:p><jats:p><jats:bold>CASE STUDY:\u2002<\/jats:bold>We report two cases of disseminated histoplasmosis associated with TMA manifestations in renal transplant recipients, including one patient with histologically documented renal microthrombi; both patients were referred for plasma exchange. After the diagnosis of histoplasmosis, the treatment plan was changed to antifungal medications, reduced immuno\u2010suppression, and supportive care, with progressive resolution of TMA manifestations.<\/jats:p><jats:p><jats:bold>CONCLUSION:\u2002<\/jats:bold>TMA occurs in transplant populations in association with infections, medications, and other factors. Appropriate management includes recognition and treatment of possible etiological factors. Disseminated histoplasmosis should be considered in transplant patients presenting with TMA.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2006.00873.x","type":"journal-article","created":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T15:10:35Z","timestamp":1148483435000},"page":"1221-1225","source":"Crossref","is-referenced-by-count":28,"title":["Disseminated histoplasmosis presenting as thrombotic microangiopathy"],"prefix":"10.1111","volume":"46","author":[{"given":"Denis\u2003M.","family":"Dwyre","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam\u2003M.","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Siechen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Sethi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas\u2003J.","family":"Raife","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,6,26]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020528"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-196603000-00003"},{"key":"e_1_2_5_4_2","doi-asserted-by":"crossref","unstructured":"NabhanC KwaanH.Current concepts in the diagnosis and management of thrombotic thrombocytopenic purpura.Hematol Oncol Clin North Am2003 177\u201099.","DOI":"10.1016\/S0889-8588(02)00085-0"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108083250604"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108083250605"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-0968.2002.00390.x"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-01-0193"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.00626.x"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.6.1765"},{"key":"e_1_2_5_11_2","first-page":"235","volume-title":"Hemostasis and thrombosis.","author":"George J","year":"2001"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830250315"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830270312"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(95)90017-9"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000013541"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199103000-00016"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-0734.2001.00044.x"},{"key":"e_1_2_5_18_2","unstructured":"MoschcowitzE.Hyaline thrombosis of the terminal arterioles and capillaries: a hitherto undescribed disease.Proc N Y Pathol Soc1924 21\u20104."},{"key":"e_1_2_5_19_2","doi-asserted-by":"crossref","unstructured":"GeorgeJ SadlerE LammleB.Platelets: thrombotic thrombocytopenic purpura.Am Soc Hematol Educ Prog2002:315\u201034.","DOI":"10.1182\/asheducation-2002.1.315"},{"key":"e_1_2_5_20_2","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1182\/blood.V77.2.306.306","article-title":"Quinine\u2010induced immune thrombocytopenia with hemolytic uremic syndrome: a new clinical entity","volume":"77","author":"Gottschall JL","year":"1991","journal-title":"Blood"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830470407"},{"key":"e_1_2_5_22_2","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1182\/blood.V73.7.2018.2018","article-title":"Microangiopathy in patients on cyclosporine prophylaxis who developed acute graft\u2010versus\u2010host disease afte HLA\u2010identical bone marrow transplantation","volume":"73","author":"Holler E","year":"1989","journal-title":"Blood"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-128-7-199804010-00004"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198112033052306"},{"key":"e_1_2_5_25_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.2340\/0001555572307309","article-title":"Hemolytic uremic syndrome in a patient with systemic sclerosis treated with cyclosporin A","volume":"72","author":"Zachariae H","year":"1992","journal-title":"Acta Dermatol Venereol"},{"key":"e_1_2_5_26_2","first-page":"2608","article-title":"Cyclosprine\u2010induced hemolytic uremic syndrome: factors that obscure its diagnosis","volume":"26","author":"Katznelson S","year":"1994","journal-title":"Transplant Proc"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196911062811901"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)64019-6"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(02)00039-9"},{"key":"e_1_2_5_30_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1399-0012.1996.tb00420.x","article-title":"Disseminated histoplasmosis in renal allograft recipients","volume":"10","author":"Peddi V","year":"1996","journal-title":"Clin Transplant"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1983.00350040093012"},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(05)70178-1"},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811263392202"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811263392203"},{"key":"e_1_2_5_35_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.11.3798"},{"key":"e_1_2_5_36_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2000.17690"},{"key":"e_1_2_5_37_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2003.00018.x"},{"key":"e_1_2_5_38_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1999.00492.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1537-2995.2006.00873.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1537-2995.2006.00873.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T01:56:09Z","timestamp":1736387769000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1537-2995.2006.00873.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,6,26]]},"references-count":37,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2006,7]]}},"alternative-id":["10.1111\/j.1537-2995.2006.00873.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1537-2995.2006.00873.x","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,6,26]]}}}