scholarly journals Moxifloxacin (Avelox) Induced Thrombotic Thrombocytopenic Purpura

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sikander P. Surana ◽  
Zahily Sardinas ◽  
Alan S. Multz
Keyword(s):  
Renal Failure ◽  
Lactate Dehydrogenase ◽  
Thrombotic Thrombocytopenic Purpura ◽  
African American Female ◽  
Shortness Of Breath ◽  
Laboratory Examination ◽  
Peripheral Smear ◽  
Thrombocytopenic Purpura ◽  
Elevated Lactate ◽  
Elevated Lactate Dehydrogenase

We report a case of a 66-year-old African-American female who presented with complaints of progressively worsening weakness, shortness of breath on minimal exertion, lethargy for the last few days, and short episodes of aphasia lasting 20–30 seconds. Prior to presentation, she was treated with two courses of moxifloxacin for sinusitis. Laboratory examination was remarkable for anemia and thrombocytopenia with elevated lactate dehydrogenase and no evidence of renal failure. Peripheral smear showed numerous schistocytes and she was diagnosed with thrombotic thrombocytopenic purpura. Moxifloxacin was identified as the offending agent. The patient was treated with prednisone and plasmapheresis. To the best of our knowledge, this is the first reported case of thrombotic thrombocytopenic purpura associated with the use of moxifloxacin. Although rare, physicians should be aware of this serious complication associated with its use.

scholarly journals Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Hafiz Rizwan Talib Hashmi ◽  
Gilda Diaz-Fuentes ◽  
Preeti Jadhav ◽  
Misbahuddin Khaja
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
African American Woman ◽  
American Woman ◽  
Successful Outcome ◽  
Peripheral Smear ◽  
Thrombocytopenic Purpura ◽  
Aggressive Management ◽  
First Case ◽  
High Index Of Suspicion ◽  
Elevated Lactate

A 49-year-old African American woman was admitted to our hospital with abdominal pain, nausea, vomiting, lethargy, and confusion. She was receiving ciprofloxacin for a urinary-tract infection prior to admission. Laboratory examination revealed anemia, thrombocytopenia, elevated lactate dehydrogenase, and serum creatinine. Peripheral smear showed numerous schistocytes, and the patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). Ciprofloxacin was identified as the offending agent. The patient received treatment with steroids and plasmapheresis, which led to rapid clinical recovery. This is the first case to our knowledge of successfully treated ciprofloxacin-induced TTP; previously reported cases had fulminant outcomes. Quinolones are an important part of the antibiotic armamentarium, and this case can raise awareness of the association between quinolones and TTP. A high index of suspicion for detection and early and aggressive management are vitally important for a successful outcome.

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 thrombocytopenic purpura and acute renal failure in adult Still's disease

1997 ◽  
Vol 12 (7) ◽  
pp. 1471-1473 ◽  
Author(s):  
J. Portoles ◽  
E. de Tomas ◽  
A. Espinosa ◽  
E. Gallego ◽  
G. S. Nieva ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Still’S Disease ◽  
Thrombocytopenic Purpura ◽  
Still's Disease ◽  
Adult Still's Disease

scholarly journals Risk Factors for Transformation to Higher-Grade Lymphoma and Its Impact on Survival in a Large Cohort of Patients With Marginal Zone Lymphoma From a Single Institution

2018 ◽  
Vol 36 (34) ◽  
pp. 3370-3380 ◽  
Author(s):  
Juan Pablo Alderuccio ◽  
Wei Zhao ◽  
Amrita Desai ◽  
Nicolas Gallastegui ◽  
Jeremy Ramdial ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lactate Dehydrogenase ◽  
Follicular Lymphoma ◽  
Lymphoid Tissue ◽  
Initial Treatment ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Competing Risk ◽  
Elevated Lactate ◽  
Elevated Lactate Dehydrogenase

Purpose Given the paucity of data on higher-grade transformation (HGT) to aggressive lymphoma in patients with marginal zone lymphoma (MZL), we report on a large cohort of patients, identify risk factors, and determine HGT impact on overall survival (OS). Methods We analyzed 453 patients with biopsy-proven MZL seen at our institution between 1995 and 2016. Kaplan-Meier, Cox proportional hazards regression, and competing risk methods were used in analyses of time-to-event outcomes. Results Thirty-four patients (7.5%) had biopsy-proven HGT to diffuse large B-cell lymphoma, including seven (21%) diagnosed at the time of initial MZL diagnosis. Among 27 incident patients, median time to HGT was 29 months (range, 1.3 to 135 months). Higher risk of HGT was observed in those with nodal/splenic MZL (subdistribution hazard ratio [SHR], 2.60; P = .023). On multivariable competing risk analysis, elevated lactate dehydrogenase (SHR, 2.71), more than four nodal sites (SHR, 2.97), and failure to achieve complete remission (CR) after initial treatment (SHR, 3.76) conveyed significantly higher risk for HGT ( P < .02). International Prognostic Index (IPI), Follicular Lymphoma IPI, and Mucosa-Associated Lymphoid Tissue Lymphoma IPI were only significant predictors of HGT univariably. Patients with HGT had shorter OS (5-year rate, 65% v 86%; P < .001). Patients who presented with HGT within 12 months since MZL diagnosis had shorter OS than those with HGT at MZL diagnosis combined with those with HGT more than 12 months later (4-year rate, 43% v 81%, P < .001). Non-CR and higher scores of IPI, Follicular Lymphoma IPI, and Mucosa-Associated Lymphoid Tissue Lymphoma IPI were the main significant predictors for shorter progression-free survival and OS. Conclusion Failure to achieve CR after initial treatment, elevated lactate dehydrogenase, and more than four nodal sites at the time of MZL diagnosis are the main predictors of increased risk of HGT. Patients with HGT have shorter OS.

scholarly journals Thrombotic Thrombocytopenic Purpura and Sickle Cell Crisis

2008 ◽  
Vol 16 (2) ◽  
pp. 224-227 ◽  
Author(s):  
Suresh G. Shelat
Keyword(s):  
Red Blood Cells ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Sickle Cell ◽  
Blood Cells ◽  
Signs And Symptoms ◽  
Activity Level ◽  
Acute Chest Syndrome ◽  
Thrombocytopenic Purpura ◽  
Nucleated Red Blood Cells ◽  
Elevated Lactate

Described is a case of acute chest syndrome in a sickle-cell patient (hemoglobin SS) who also developed signs and symptoms of thrombotic thrombocytopenic purpura, including thrombocytopenia and hemolysis (anemia, elevated lactate dehydrogenase, presence of schistocytes, dark-colored plasma, and elevations in nucleated red blood cells). The ADAMTS13 activity level was normal. Discussed are the diagnosis and therapeutic management issues and the challenges of differentiating the vasoocclusive and hemolytic complications of sickling red blood cells from the thrombotic microangiopathy of thrombotic thrombocytopenic purpura.

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