EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Post-Partum Thrombotic Thrombocytopenic Purpura (TTP) in a Patient with known Idiopathic (Immune) Thrombocytopenic Purpura: a case report and review of the literature



Post-Partum Thrombotic Thrombocytopenic Purpura (TTP) in a Patient with known Idiopathic (Immune) Thrombocytopenic Purpura: a case report and review of the literature



Journal of Medical Case Reports 12(1): 147-147



Incidences of immune thrombocytopenic purpura occur in 1 in every 1000-10,000 pregnancies accounting for 3% of all thrombocytopenic pregnancies. A pre-existing immune thrombocytopenic purpura is known to be a risk factor for developing thrombocytopenia during pregnancy. We present here the treatment regime and management of a patient with known immune thrombocytopenic purpura who developed postpartum thrombotic thrombocytopenia with atypical response to traditional therapy. Pregnant women are more vulnerable to immune thrombocytopenic purpura or thrombotic thrombocytopenia. Pregnancy or postpartum thrombotic thrombocytopenia accounts for 10-25% of all thrombotic thrombocytopenia. This case report deals with the treatment regime and management of a patient with known immune thrombocytopenic purpura who developed postpartum thrombotic thrombocytopenia. A 30-year-old Middle Eastern woman, with a prior diagnosis of chronic immune thrombocytopenic purpura had remained off-the-treatment for many years. After primary unexplained infertility for 8 years, for which she underwent six failed trials of in vitro fertilization, she delivered a healthy baby through caesarean section. Two days post-surgery, she had persistent thrombocytopenia, ecchymoses, bruises, and hemolysis. Her blood film revealed leukoerythroblastic anemia. Her blood tests also revealed a very low level of haptoglobin, and low level of ADAMTS13. A diagnosis of thrombotic thrombocytopenia was suspected. Plasma exchange therapy was started with partial response. We showed that rituximab in conjunction with mycophenolate mofetil following plasma exchange therapy was effective in controlling the low platelet count in our patient. Rituximab in conjunction with mycophenolate mofetil following plasma exchange therapy was effective in controlling the low platelet count in our patient. Only two doses of rituximab were sufficient to normalize our patient. We present here a case of safe and effective use of rituximab in pregnancy-induced thrombotic thrombocytopenia.

(PDF emailed within 0-6 h: $19.90)

Accession: 065418531

Download citation: RISBibTeXText

PMID: 29855343

DOI: 10.1186/s13256-018-1692-1



Related references

Concurrent thrombotic thrombocytopenic purpura and immune thrombocytopenic purpura in an HIV-positive patient: case report and review of the literature. American Journal of Hematology 51(1): 73-78, 1996

Post-partum management in a patient affected by thrombotic thrombocytopenic purpura: case report and review of literature. Clinical and Experimental Obstetrics & Gynecology 42(1): 90-94, 2015

Sequential occurrence of thrombotic thrombocytopenic purpura, essential thrombocythemia, and idiopathic thrombocytopenic purpura in a 42-year-old African-American woman: a case report and review of the literature. Journal of Medical Case Reports 6: 93-93, 2012

Intravenous prostacyclin (as epoprostenol) infusion in thrombotic thrombocytopenic purpura. Four case reports and review of the literature. Italian Cooperative Group for Thrombotic Thrombocytopenic Purpura. Haematologica 79(5): 429-437, 1994

Inherited thrombotic thrombocytopenic purpura mimicking immune thrombocytopenic purpura during pregnancy: a case report. Journal of Medical Case Reports 12(1): 15-15, 2018

Thrombotic thrombocytopenic purpura complicating immune thrombocytopenic purpura--a case report. American Journal of Hematology 86(4): 383-383, 2011

Post-appendectomy thrombotic thrombocytopenic purpura: a case report and review of the literature. American Journal of Hematology 82(3): 224-228, 2006

Rituximab for the treatment of refractory idiopathic thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP): report of three cases. American Journal of Hematology 78(1): 49-54, 2004

Concurrent thrombotic thrombocytopenic purpura and immune thrombocytopenic purpura in a patient with metastatic neuroendocrine tumour successfully treated with rituximab-CVP. Bmj Case Reports 2010: -, 2013

Cocaine-induced microangiopathic hemolytic anemia mimicking idiopathic thrombotic thrombocytopenic purpura: a case report and review of the literature. Journal of Clinical Apheresis 29(5): 284-289, 2015

Idiopathic thrombotic thrombocytopenic purpura without hemolytic anemia a case and literature review. Revista Medica del Instituto Mexicano del Seguro Social 18(2): 143-150, 1979

Relapsed/refractory acquired thrombotic thrombocytopenic purpura in a patient with Sjögren syndrome: Case report and review of the literature. Medicine 97(43): E12989-E12989, 2018

Alteration of ADAMTS13 antigen levels in patients with idiopathic thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura and systemic lupus erythematosus. Thrombosis and Haemostasis 95(4): 749-750, 2006

The spectrum of thrombotic thrombocytopenic purpura: a clinicopathologic demonstration of tacrolimus-induced thrombotic thrombocytopenic purpura in a lung transplant patient. Southern Medical Journal 101(7): 744-747, 2008

Increased serum levels of thrombopoietin in patients with thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, or disseminated intravascular coagulation. Blood Coagulation & Fibrinolysis 8(6): 345-349, 1997