Objective: To report on the development and treatment of thrombotic microangiopathy, an atypical cause of acute renal failure in patients with acute pancreatitis.
Design: Case reports.
Setting: A 21-bed medical intensive care unit at an university hospital.
Patients: Two men with acute pancreatitis presented with acute renal failure, neurological manifestations, haemolytic anaemia and thrombocytopenia. Both patients required intensive care.
Measurements: Fragmented red cell count; levels of haptoglobin, amylase and lipase; serological testing for Escherichia Coli O157; computed tomography of the abdomen.
Main Results: The patients' courses were rapidly favourable after daily plasma exchange. A review of the existing medical literature was also undertaken.
Conclusion: As thrombotic microangiopathy may be life-threatening without administration of fresh frozen plasma or plasma exchange, physicians should consider this disease as a possible cause of acute renal failure in patients with acute pancreatitis.
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