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Thrombotic thrombocytopenic purpura and pregnancy: report of four cases and literature review
Author(s) -
Shamseddine Ali,
Chehal Aref,
Usta Ihab,
Salem Ziad,
ElSaghir Nagi,
Taher Ali
Publication year - 2004
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.10076
Subject(s) - medicine , thrombotic thrombocytopenic purpura , pregnancy , thrombocytopenic purpura , intensive care medicine , platelet , obstetrics , dermatology , immunology , genetics , biology
Thrombotic thrombocytopenic purpura (TTP) is a severe life‐threatening hematological disorder affecting the microcirculation of multiple organ systems. Infection, pregnancy, cancer, drugs, and surgery are frequently associated with the initial episodes and relapses. Women who are either pregnant or in the postpartum period make up 10–25% of TTP patients, suggesting the interrelationship between TTP and pregnancy. The introduction of aggressive treatment with plasma transfusion and plasmapheresis has improved maternal and fetal survival rates. We report four cases of pregnancy‐related TTP, describing the clinical course of patients, including response to therapy and pregnancy outcomes. Three out of four (75%) patients were treated by daily single session of plasmapheresis for a period ranged between 3 and 23 days. One patient had complete response to treatment with no sequelae, the second patient had resistant disease and died due to multiorgan failure, while the third patient had complete response after 2 episodes of TTP, which was complicated by intrauterine fetal growth retardation and death. Review of the previously reported cases of pregnancy‐related TTP and the current treatment options for this rare condition are discussed also. J. Clin. Apheresis 19:5–10. © 2004 Wiley‐Liss, Inc.