American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2019, 7(10), 240-243
DOI: 10.12691/ajmcr-7-10-5
Open AccessArticle

Late Presentation of Carfilzomib Associated Thrombotic Microangiopathy

Michael Haddadin1, Mohammad Al-Sadawi1, Sally Madanat2, Eric Tam3, Evelyn Taiwo3, Carol Luhrs3 and Samy I Mcfarlane1,

1Department of internal Medicine, State University of New York-Downstate, Brooklyn, New York, USA

2Saint James School of Medicine St. Vincent, Cane Hall Road, Arnos Vale, St Vincent & the Grenadines

3Department of Hematology & Oncology, State University of New York-Downstate, Brooklyn, New York, USA

Pub. Date: July 31, 2019

Cite this paper:
Michael Haddadin, Mohammad Al-Sadawi, Sally Madanat, Eric Tam, Evelyn Taiwo, Carol Luhrs and Samy I Mcfarlane. Late Presentation of Carfilzomib Associated Thrombotic Microangiopathy. American Journal of Medical Case Reports. 2019; 7(10):240-243. doi: 10.12691/ajmcr-7-10-5


Multiple Myeloma (MM) is a plasma cell disorder characterized by abnormal proliferation of plasma cells resulting in overproduction of paraprotein. Proteasome inhibitors (PI) have been a corner stone for the treatment of MM. Thrombotic Microangiopathy (TMA) is a recent hematological adverse event that has newly been recognized in multiple PI. TMA leads to end-organ damage and infarction by microthromobi. TMA pathophysiology is not well understood and has multiple etiologies. We present a case of PI-induced TMA, along with literature review of cases diagnosed from 2008-2018. Unique to our case is the onset of presentation, more than 24 months after initiating carfilzomib. Our case highlights the need for vigilant monitoring and the importance of clinical suspicion in patients at risk for TMA.

carfilzomib thrombotic microangiopathy proteosome inhibitos

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