Intestinal complications of adult thrombotic microangiopathy. Four cases and review of the literature.

We report four cases of adult thrombotic microangiopathy associating diarrh ea with severe ischemic colitis. In one case, the intestinal complications was severe and diffuse ischemic colitis, in two cases an inaugural colonic perforation requiring colectomy and in the last case a massive mesenteric i nfarct, In three cases, histologic examination showed vessel occlusion with microthrombi. Despite treatment with plasma exchange and plasma infusion, death ensued in two cases. Principally discribed in childhood thrombotic mi croangiopathy, intestinal complications occur exceptionally in adult thromb otic microangiopathy and are associated with a poor prognosis. Inaugural is chemic colitis revealing an adult thrombotic microangiopathy is also uncomm on and thrombotic microangiopathy could be evoked in all patients presentin g acute ischemic colitis.