Cocaine-induced microangiopathic hemolytic anemia mimicking idiopathic thrombotic thrombocytopenic purpura: A case report and review of the literature

2014 ◽  
Vol 29 (5) ◽  
pp. 284-289 ◽  
Author(s):  
Shelley Odronic ◽  
NurJehan Quraishy ◽  
Pooja Manroa ◽  
Yelena Kier ◽  
Anna Koo ◽  
...  
Keyword(s):  
Case Report ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Review Of The Literature ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura with typical pentalogy in a child: a case report and literature review

2021 ◽  
Author(s):  
Qian Wan ◽  
Yao Ye ◽  
Xiaohong Zhong ◽  
Zhongjin Xu ◽  
Jian Li
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Renal Insufficiency ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Thrombotic Microangiopathy ◽  
Typical Case ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura ◽  
Life Threatening

Abstract Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy with clinical quintuple symptoms, including fever, thrombocytopenia, microangiopathic hemolytic anemia, neurological symptoms, and renal insufficiency. TTP onset in children is rare, and the percentage of acute TTP with these five symptoms at the same time is <10%. In this study, we reported a typical case of TTP onset in a child with clinical quintuple symptoms.

scholarly journals Relapse of congenital thrombotic thrombocytopenic purpura, after spontaneous remission, in a second-trimester primigravida: case report and review of the literature

2017 ◽  
Vol 135 (5) ◽  
pp. 491-496 ◽  
Author(s):  
Donavan de Souza Lúcio ◽  
Jacqueline Foelkel Pignatari ◽  
Marcelo Gil Cliquet ◽  
Henri Augusto Korkes
Keyword(s):  
Case Report ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Specific Treatment ◽  
Spontaneous Remission ◽  
Adamts13 Activity ◽  
Second Trimester ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura ◽  
Uremic Syndrome

ABSTRACT CONTEXT: Thrombotic microangiopathy syndrome or thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) describes distinct diseases sharing common pathological features: microangiopathic hemolytic anemia and thrombocytopenia, without any other apparent cause. CASE REPORT: An 18-year-old second-trimester primigravida presented with a history of fifteen days of intense weakness, followed by diarrhea over the past six days. She reported having had low platelets since childhood, but said that she had never had bleeding or menstrual abnormalities. Laboratory investigation showed anemia with schistocytes, thrombocytopenia and hypohaptoglobulinemia. Red blood cell concentrate and platelet transfusions were performed. The hypothesis of TTP or HUS was put forward and ADAMTS13 enzyme activity was investigated. The patient evolved with increasing platelet counts, even without specific treatment, and she was discharged. One month afterwards, she returned presenting weakness and swollen face and legs, which had developed one day earlier. The ADAMTS13 activity was less than 5%, without presence of autoantibodies. Regarding the two previous admissions (at 9 and 16 years of age), with similar clinical features, there was spontaneous remission on the first occasion and, on the second, the diagnosis of TTP was suspected and plasmapheresis was performed, but ADAMTS13 activity was not investigated. CONCLUSION: To date, this is the only report of congenital TTP with two spontaneous remissions in the literature This report reveals the importance of suspicion of this condition in the presence of microangiopathic hemolytic anemia and thrombocytopenia without any other apparent cause.

scholarly journals Thrombotic thrombocytopenic purpura with COVID-19 as an unforeseen complication: A case report.

2021 ◽  
Author(s):  
Muhammad Zain Mushtaq ◽  
Saad Bin Zafar Mahmood ◽  
Usman Shaikh ◽  
Syed Ahsan Ali
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Peripheral Blood ◽  
Blood Film ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura ◽  
Worsening Renal Function ◽  
Peripheral Blood Film

This article reports an association of thrombotic thrombocytopenic purpura(TTP) with COVID-19. A 49-year old male presented with fever, diarrhea and altered mentation, was found to have COVID-19. On sixth hospital day, he developed thrombocytopenia, microangiopathic hemolytic anemia with schistocytes on peripheral blood film and worsening renal function signifying TTP.

scholarly journals Thrombotic Thrombocytopenic Purpura: A Case Presenting with Acute Ischemic Colitis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Joseph R. H. See ◽  
Tarek Sabagh ◽  
Christopher J. Barde
Keyword(s):  
Case Report ◽  
Renal Disease ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Ischemic Colitis ◽  
Disease Process ◽  
Good Prognosis ◽  
Atypical Presentation ◽  
Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura (TTP) consists of the pentad of thrombocytopenia, hemolytic anemia, fever, neurologic abnormalities, and renal disease. We present a case report of acute TTP following a bout of ischemic colitis. This report reminds the clinician that ischemic colitis can be an atypical presentation of TTP. The prompt recognition and treatment of this disease process resulted in a good prognosis for our patient.

scholarly journals A Rare Case of Thrombotic Thrombocytopenic Purpura Caused by Acute Pancreatitis

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Emin Gemcioglu ◽  
Mehmet Kayaalp ◽  
Merve Caglayan ◽  
Ahmet Ceylan ◽  
Mehmet Sezgin Pepeler
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Neurological Disorders ◽  
Rare Case ◽  
Rare Complication ◽  
Microangiopathic Hemolytic Anemia ◽  
Peripheral Smear ◽  
Thrombocytopenic Purpura

Thrombotic Thrombocytopenic Purpura is a syndrome of microangiopathic hemolytic anemia accompanied by thrombocytopenia, neurological disorders, renal failure and fever. Acute pancreatitis is a rare cause of Thrombotic Thrombocytopenic Purpura and this manifestation, at the same time, is a rare complication of acute pancreatitis. Thrombotic Thrombocytopenic Purpura is induced in acute pancreatitis by poorly understood mechanism, which involves multiple pathways apart from only ADAMTS-13 deficiency. Here, we analyze the case of a 47-year-old female who presented with an acute pancreatitis. She was diagnosed with Thrombotic Thrombocytopenic Purpura and an acute pancreatitis at the same time, with thrombocytopenia and peripheral smear findings at presentation. Therefore, Thrombotic Thrombocytopenic Purpura secondary to the pancreatitis was considered in this case. In this work, we have discussed details of our case and the different mechanisms involved in pathogenesis of Thrombotic Thrombocytopenic Purpura in acute pancreatitis and their outcome with prompt management.

scholarly journals Thrombotic Thrombocytopenia Purpura Case Series in Skmc 2016-2017

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4799-4799
Author(s):  
Mohamed Abu Haleeqa ◽  
Hanan Al Raeesi ◽  
Fatima Alkaabi
Keyword(s):  
Renal Failure ◽  
Mortality Rate ◽  
Plasma Exchange ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Case Series ◽  
Therapeutic Plasma Exchange ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura ◽  
Patient Reported

Background and Purpose Thrombotic thrombocytopenic purpura (TTP) is a heterogeneous disease primarily characterized by thrombocytopenia and microangiopathic hemolytic anemia. Therapeutic plasma exchange has dramatically improved mortality, allowing for emergence of refractory, relapsing, and atypical presentations. in this case series we aim to present our institutional data for Apheresis in Sheikh khalifa medical City in AbuDhabi. We will also present patient demographic and clinical presentation and treatment protocol we use Methodology -Case series with Retrospective review. -Routine laboratory tests such as peripheral blood cell counts, reticulocyte count, coagulation profile, serum lactate dehydrogenase (LDH), bilirubin, serum creatinine, cardiac enzymes, and urinalysis, were performed. -ADAMTS13 levels and inhibitor titer were determined for all patient in outside lab -Baseline demographic characteristics were calculated in frequencies and percentages. (include age ,Gender , clinical manifestations and treatment strategy) Results and Discussions thrombotic thrombocytopenic purpura (TTP) pentad consisting of fever, thrombocytopenia, microangiopathic hemolytic anemia (MAHA), neurological abnormalities, and renal failure. less than 5 % of patient reported in literature have all associated clinical features. -Total of 10 patients M:F 4:2 , Median Age 44yr 50% presented with Neurological manifestations and renal disease , 30% presented with Fever only 20% had cardiac manifestation on admission . None of the patient presented with all 5 pentad. -All patients received TPE , steroid . -90 % of the patients received Rituximab except for 1 because of Allergy. -All patients has low ADAMTS 13 , except one has normal ADAMTS13 but came with relapse and on first admission had low ADAMTS13 -All patient presented with MAHA and TCP except 2 patient whom had normal Hb but significant schistocytes on peripheral blood with TCP both patient where relapsed cases. -3 patient were relapsed 7 de novo , the 3 relapsed cases all did not receive Rituximab in first remission . One of them relapsed twice but did not received Rituximab due to allergy -Although some publication include large number of TTP patients, but only few case reports have evaluated the clinical feature, laboratory parameters and therapeutic outcome of TTP. Without treatment, TTP is almost uniformly fatal with a mortality rate approaching 90%. With the timely institution of therapeutic plasma exchange (TPE) mortality decreases to about 10%-20%. A disintegrin and metalloprotease with thrombospondin Type 1 motif, Member 13 (ADAMTS13) levels less than 5% are a hallmark of TTP. We do ADAMTS 13 Activity and inhibitor titre levels in outside facility TAWAM hospital with turn-around time of 7 days which is helpful in planning Rituximab treatment. with availability of Rituximab our relapse rates are low but not zero Conclusions -Thrombotic thrombocytopenic purpura (TTP) pentad consisting of fever, thrombocytopenia, microangiopathic hemolytic anemia (MAHA), neurological abnormalities, and renal failure. -5 % of patient reported in literature have all associated clinical features. -We found that majority of patient presented with evidence of thrombocytopenia and MAHA only. -Without treatment, TTP is almost uniformly fatal with a mortality rate approaching 90%. With the timely institution of therapeutic plasma exchange (TPE) mortality decreases to about 10%-20%. -TPE ,steroid and rituximab was very effective in achieving sustain remission in 100% of ours patients with median follow up 8 month -More awareness is needed for early diagnosis and early referral to centers with appropriate tertiary care facilities. Figure Disclosures No relevant conflicts of interest to declare.

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