[Distal coronary thrombosis during L-asparaginase treatment for an acute lymphoblastic leukaemia]. / Thrombose coronaire distale compliquant une leucémie aiguë lymphoblastique traitée par asparaginase.

A 53-year-old man is treated by L-asparaginase for an acute lymphoblastic leukaemia. He received anti thrombin infusions. A systematic electrocardiogram showed an asymptomatic subepicardium ischemia without troponin elevation. Echocardiography and heart magnetic resonance imaging showed an apical thrombus facing a zone of myocardial necrosis. A thrombus regression was observed under anticoagulation. Atypical and asymptomatic coronary thrombosis may occur following L-asparaginase treatment. Regular electrocardiogram monitoring is proposed along this treatment. Arterial thrombosis associated with anti tumor chemotherapies are reviewed.

[Thrombotic microangiopathy following kidney transplantation revealing factors H and I deficiencies]. / Microangiopathie thrombotique de novo post-transplantation rénale révélant un déficit en facteur H et en facteur I.

A 52-year-old man with an end stage renal failure of undetermined aetiology was hemodialysed in 2002. He received a cadaveric kidney transplantation in 2004. After an episode of diarrhea, a thrombotic microangiopathy was diagnosed in July 2009 and during this episode, a low C3 serum level was identified. Plasma exchanges were beneficial. Exploration of the low C3 serum level revealed both factor H and factor I deficiencies. We think that the renal failure of undetermined aetiology was probably an unnoticed haemolytic and uremic syndrome which recurred more than five years after transplantation.