Yu Q.Suknuntha K.Zhong W.Matson D.R.Hess A.S.Rose W.N.Mahidol University2023-06-182023-06-182022-11-01OBM Transplantation Vol.6 No.2 (2022)https://repository.li.mahidol.ac.th/handle/20.500.14594/85383We report a case of thrombotic microangiopathy (TMA) diagnosed in the kidney allograft of a 59-year-old woman who had developed plasmacytoma type monomorphic posttransplant lymphoproliferative disorder (PTLD) 30 years after a simultaneous pancreas and kidney transplant. This report demonstrates a rare etiology of TMA in a kidney allograft occurring in association with PTLD-associated monoclonal gammopathy. The main teaching points are: 1) PTLD may be considered in the work-up of a new TMA in the immunosuppressed post-transplant setting, and 2) a paraprotein-associated condition should be considered as clinically relevant coexistent in a patient with TMA because paraproteins are over-represented in patients with otherwise unexplained TMAs.MedicineArticleSCOPUS10.21926/obm.transplant.22021602-s2.0-8514410179025775820