Document Detail


The association of pregnancy with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.
MedLine Citation:
PMID:  12913787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome occurs more commonly in women and among women is commonly associated with pregnancy. Case series of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome from 1964 to 2002 were reviewed (1) to document the reports of occurrence of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome during pregnancy and (2) to search for reports of women with congenital or familial thrombotic thrombocytopenic purpura-hemolytic uremic syndrome who were initially diagnosed during their first pregnancy. The time during pregnancy with greatest risk for development of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome is near term and during the postpartum period. This is also the time of greatest risk for thrombotic events and for the occurrence of other pregnancy-related syndromes: preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. These other syndromes may also be associated with thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, and renal insufficiency, making their distinction from thrombotic thrombocytopenic purpura-hemolytic uremic syndrome difficult or impossible. The occurrence of preeclampsia and related syndromes, the hypercoaguable state that occurs in late pregnancy and postpartum, and the progressively decreasing concentration of ADAMTS13 that occurs during late pregnancy may combine to increase the risk for occurrence of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.
Authors:
James N George
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in hematology     Volume:  10     ISSN:  1065-6251     ISO Abbreviation:  Curr. Opin. Hematol.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-12     Completed Date:  2004-03-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9430802     Medline TA:  Curr Opin Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-44     Citation Subset:  IM    
Affiliation:
The University of Oklahoma Health Sciences Center, Hematology-Oncology Section, PO Box 26901, Oklahoma City, OK 73190, USA. Jim-George@OUHSC.edu
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MeSH Terms
Descriptor/Qualifier:
ADAM Proteins
Female
Hemolytic-Uremic Syndrome / blood,  diagnosis*,  etiology*
Humans
Metalloendopeptidases / deficiency
Pregnancy
Pregnancy Complications, Hematologic / blood,  diagnosis*
Purpura, Thrombotic Thrombocytopenic / blood,  diagnosis*,  etiology*
Chemical
Reg. No./Substance:
EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/ADAMTS13 protein, human; EC 3.4.24.-/Metalloendopeptidases

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


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