Document Detail


Thrombotic thrombocytopenic purpura: recognition and management.
MedLine Citation:
PMID:  20058208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombotic thrombocytopenic purpura is a life-threatening multisystem disorder that represents both a diagnostic and a management challenge to clinicians. Early recognition of the condition coupled with rapid institution of plasma exchange has led to a dramatic improvement in prognosis. Studies performed over the past decade have elucidated the predominant pathophysiology, stemming from a deficiency of ADAMTS13, that accounts for the widespread microvascular deposition of platelet-von Willebrand factor in many sites, including the brain, kidney, and mesenteric vessels. However, in light of the mortality rate of 10-20%, much work remains to be done to translate advances in our understanding of pathophysiology into clinical practice. Improvements in medical management using immunosuppressive and other drugs are being actively explored in clinical trials. Agents that target ADAMTS13 autoantibody production by B-cells, such as anti-CD20 monoclonal antibodies, have the potential to shorten the duration of plasma exchange treatment, reduce relapses, and transform the management of this once enigmatic disorder.
Authors:
Joseph E Kiss
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  International journal of hematology     Volume:  91     ISSN:  1865-3774     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-25     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-45     Citation Subset:  IM    
Affiliation:
Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh School of Medicine, 3636 Blvd. of the Allies, Pittsburgh, PA 15213, USA. jkiss@itxm.org
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MeSH Terms
Descriptor/Qualifier:
ADAM Proteins / immunology
Autoantibodies / blood
Humans
Immunosuppressive Agents / therapeutic use*
Plasma Exchange*
Purpura, Thrombotic Thrombocytopenic / diagnosis*,  drug therapy*,  immunology
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Immunosuppressive Agents; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/ADAMTS13 protein, human

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


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