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Pericardial effusion in pediatric SCT recipients with thrombotic microangiopathy

Bone Marrow Transplantation volume 49, pages 862–863 (2014)Cite this article

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Pericardial effusion (PEF) is a known complication of hematopoietic SCT (HSCT) that can result in significant morbidity and even death by causing acute cardiac tamponade.1,2 The exact incidence and risk factors are not well described, but retrospective reviews report PEF occurring in 0.2–19% of HSCT patients.1,3,4 Age, gender, preparative conditioning regimen, GVHD and CMV or EBV viremias have been suggested as potential risk factors.1 The initial symptoms of PEF can be nonspecific, thus early detection and identification may improve patient outcomes.

In our clinical practice, we observed that patients with transplant-associated thrombotic microangiopathy (TA-TMA) tend to have clinically significant PEFs requiring medical or surgical interventions. TA-TMA occurs in ~25–30% of HSCT patients and is characterized by vascular endothelial damage leading to microangiopathic hemolytic anemia, thrombocytopenia and renal injury with multiorgan involvement and polyserositis in severe cases.5,6 Mortality in patients with severe multiorgan TA-TMA is as high as 90%.

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Authors and Affiliations

  1. Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    D Lerner, C Dandoy, S M Davies & S Jodele

  2. Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    R Hirsch

  3. Division of Nephrology, The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA

    B Laskin

Authors
  1. D Lerner
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  2. C Dandoy
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  3. R Hirsch
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  4. B Laskin
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  5. S M Davies
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  6. S Jodele
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Correspondence to C Dandoy.

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Lerner, D., Dandoy, C., Hirsch, R. et al. Pericardial effusion in pediatric SCT recipients with thrombotic microangiopathy. Bone Marrow Transplant 49, 862–863 (2014). https://doi.org/10.1038/bmt.2014.40

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