Document Detail


Postpartum plasma exchange in a woman with suspected thrombotic thrombocytopenic purpura (TTP) vs. hemolysis, elevated liver enzymes, and low platelet syndrome (HELLP): a case study.
MedLine Citation:
PMID:  20830946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The occurrence of a hypercoagulable state and decreasing concentration of ADAMTS 13 in late pregnancy and during the postpartum period increases the risk for a woman to develop life-threatening thrombotic thrombocytopenic purpura (TTP). This is also the time of great risk for the more common obstetric complications of preeclampsia; eclampsia; and hemolysis, elevated liver functions tests, low platelets (HELLP) syndrome. These conditions are associated with high maternal and perinatal mortality. Differential diagnosis may be difficult due to the overlapping of clinical and laboratory findings, including thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, and renal insufficiency, making it difficult or impossible to distinguish them from TTP. Management of microangiopathic disorders encountered during pregnancy differ; therefore, an accurate diagnosis is required. Outcomes of TTP without plasma exchange therapy (TPE) are almost uniformly fatal. Early recognition and management of symptoms with prompt and aggressive TPE is essential when TTP is suspected.
Authors:
Linda Myers
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Nephrology nursing journal : journal of the American Nephrology Nurses' Association     Volume:  37     ISSN:  1526-744X     ISO Abbreviation:  Nephrol Nurs J     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-09-13     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909377     Medline TA:  Nephrol Nurs J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  399-402     Citation Subset:  N    
Affiliation:
Acute Care Renal/Apheresis Unit, University of Virginia Health System, Charlottesville, VA, USA. llm3m@hscmail.mcc.virginia.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Diagnosis, Differential
Early Diagnosis
Female
HELLP Syndrome / blood,  diagnosis,  etiology,  therapy*
Hemolysis
Humans
Liver Function Tests
Plasma Exchange / methods*,  nursing
Pre-Eclampsia / etiology
Pregnancy
Pregnancy, Multiple
Puerperal Disorders / blood,  diagnosis,  etiology,  therapy*
Purpura, Thrombotic Thrombocytopenic / blood,  diagnosis,  etiology,  therapy*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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