Evidence map›Paper›PMID 40046371›Full record

ArticleCureus2025

Ulcerative Colitis Gone Rogue: A Case of Complement-Mediated Thrombotic Microangiopathy in Inflammatory Bowel Disease.

Eugene K Yeboah, Aye M Thida, Ramtin Moradi, Dedipya Bhamidipati, Prashil Dave, Muhammad Azhar, Mary Mallapalil, Isha Puri

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Eugene K YeboahInternal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Aye M ThidaHematology and Oncology, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Ramtin MoradiHematology and Oncology, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Dedipya BhamidipatiInternal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Prashil DaveInternal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Muhammad AzharNephrology, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Mary MallapalilNephrology, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Isha PuriNephrology, State University of New York Downstate Health Sciences University, Brooklyn, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We present an unusual case of complement-mediated thrombotic microangiopathy (formerly known as atypical hemolytic uremic syndrome) associated with inflammatory disease in a young patient. A 26-year-old male patient with no significant past medical history presented to our emergency department with a four-week history of diffuse, moderate, cramping, non-radiating abdominal pain with no known aggravating or relieving factors. Abdominal pain was associated with nausea, vomiting, and bloody stools. His physical examination revealed pale conjunctiva, tachycardia, and mild tenderness in the lower abdomen. The patient's laboratory results indicated severe anemia with a hemoglobin level of 2.9 g/dL, an elevated white blood cell count of 52.86 K/uL, a low platelet count of 107 K/uL, and evidence of acute kidney injury, with a blood urea nitrogen level of 87.0 mg/dL and a serum creatinine level of 8.32 mg/dL. Further work-up showed hemolysis, characterized by low haptoglobin levels, elevated lactate dehydrogenase, and a positive direct Coombs test for both anti-IgG and anti-C3 antibodies. A computed tomography angiogram (CTA) of the abdomen and pelvis showed pancolitis. Severe inflammation was noted during a flexible sigmoidoscopy, and pathology results revealed chronic inflammation/chronic colitis. A renal biopsy performed showed thrombotic microangiopathic changes with complement deposition. The patient was started on eculizumab, which ultimately resulted in improvements in anemia, thrombocytopenia, and renal function. Our case stands out as the complexity of the diagnosis warrants awareness of complement-mediated thrombotic microangiopathy (TMA). The introduction of eculizumab, a terminal complement blockade therapy, has revolutionized the management of complement-mediated TMA, as early initiation of eculizumab treatment has shown significant reductions in disease progression to end-stage kidney disease and its related complications.

Indexed as

adamts-13 deficiencyalternate pathway complementatypical huscomplement dysregulationcomplement-mediated thrombotic microangiopathyeculizumabthrombotic microangiopathy (tma)thrombotic thrombocytopenic purpura (ttp)-like syndrome

Identifiers

PMID40046371
PMCPMC11882344

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