The potential role of complements in cocaine-induced thrombotic microangiopathy.

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Thrombotic microangiopathy (TMA) is a rare disorder characterized by microvascular injury and occlusion resulting in tissue ischemia and dysfunction. TMA occurs in a variety of settings including cocaine use. Although cocaine is widely used in the United States, cocaine-associated TMA is only rarely reported. Therefore, other factors may predispose cocaine users to the development of TMA. Emerging evidence indicates that cocaine activates complements. Therefore, complement activation may contribute to the development of cocaine-induced TMA. Here, we report a cocaine user who presented with renal failure. Renal biopsy demonstrated TMA. Laboratory tests revealed reduced serum complement C3 and normal complement C4 levels indicative of alternative complement activation. We postulate that complement activation is involved in the pathogenesis of cocaine-induced TMA.





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Dejman, Adriana, Seyed Navid Alavi, David B Thomas, Alexandra Stefanovic, Arif Asif and Ali Nayer (2018). The potential role of complements in cocaine-induced thrombotic microangiopathy. Clinical kidney journal, 11(1). pp. 26–28. 10.1093/ckj/sfx061 Retrieved from

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David Thomas

Adjunct Professor in the Department of Pathology

Alexandra Stefanovic

Associate Professor of Medicine

I am convinced that caring for patients with malignant hematologic diseases requires not only up-to-date medical knowledge, but also an understanding of the individual patient's needs and circumstances. I encourage patients to take an active role in their treatment and recovery and I work with them to develop an individualized treatment plan that includes the most advanced therapies available today. My practice focuses primarily on disorders of the lymphatic system (Hodgkin and non-Hodgkin lymphoma and chronic lymphocytic leukemia). As an integral part of my clinical activities, I am dedicated to teaching young physicians at all levels of training and educating the next generation of hematologists.

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