Post Renal Angioplasty Ticagrelor Induced Thrombotic Microangiopathy in Undiagnosed Large Vessel Vasculitis: A Case Report

Ticagrelor is an uncommon cause of thrombotic microangiopathy (TMA). We report a 25-year-old female with uncontrolled hypertension. She presented with acute kidney disease secondary to bilateral renal artery thrombosis. She underwent successful angioplasty with stenting and was started on aspirin and ticagrelor. Within 24 hours, she developed TMA, which was refractory to five cycles of plasmapheresis. Rituximab treatment led to complete hematologic and renal recovery, suggesting an immune-mediated cause.