| Thrombocytopenic purpura and cardiomyopathy in pregnancy reversed by combined plasma exchange and infusion. | |
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MedLine Citation:
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PMID: 12071941 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Thrombocytopenia and hemolytic anemia have been seen with thrombotic thrombocytopenic purpura (TTP), HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), and hemolytic uremic syndrome (HUS). Differentiating between TTP, HUS, and HELLP syndrome is often difficult. Coexistence of TTP and HELLP is possible. Cardiomyopathy occurring in pregnancy can be idiopathic or associated with TTP. We describe a previously healthy woman who developed thrombocytopenia and hemolysis at 34 wk gestation. The patient underwent delivery after transfusion with platelets and RBCs. The suspicion of TTP was raised, and plasma exchange was begun by the third hospital day. On the seventh day of treatment, the patient developed shortness of breath, and an echocardiogram showed global hypokinesis with an ejection fraction of 25%. Plasma infusion, one unit q 4 h, was initiated in addition to the daily plasma exchange. The patient improved and her ejection fraction normalized. Plasma exchange and infusion and corticosteroids were gradually tapered off. von Willebrand factor (vWF) protease activity in the plasma upon transfer was completely deficient with the presence of inhibitor. This case illustrates that vWF protease assay and detection of inhibitor can be used for the diagnosis of TTP during pregnancy; and a severe cardiomyopathy in TTP can be reversed rapidly with combined plasma exchange and infusion. |
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Authors:
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Elizabeth M Cosmai; Leopold Puzis; H-M Tsai; Eric C-Y Lian |
Publication Detail:
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Type: Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: European journal of haematology Volume: 68 ISSN: 0902-4441 ISO Abbreviation: Eur. J. Haematol. Publication Date: 2002 Apr |
Date Detail:
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Created Date: 2002-06-19 Completed Date: 2002-07-24 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8703985 Medline TA: Eur J Haematol Country: Denmark |
Other Details:
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Languages: eng Pagination: 239-42 Citation Subset: IM |
Affiliation:
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Division of Hematology/Oncology, University of Miami and Veterans Affairs Medical Center, Florida, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiomyopathies / therapy* Erythrocyte Transfusion* Female Humans Plasma Exchange* Platelet Transfusion* Pregnancy Pregnancy Complications, Cardiovascular / therapy* Purpura, Thrombocytopenic / therapy* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL62131/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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