BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a rare cause of severe thrombocytopenia in pregnancy. METHODS: Six pregnancies in five patients with TTP were followed prospectively over 5 years. Ultralarge von Willebrand factor (ULvWF) multimers and cleaving protease (cp) levels were measured. RESULTS: TTP relapsed, complicating four of the six pregnancies. Of three patients who relapsed, two had complete or partial vWF-cleaving protease (vWF-cp) deficiency, and one had a normal vWF-cleaving protease level. In all three we found abnormal UL multimers. The two women who did not relapse had normal vWF-cleaving protease level and an absence or loss of UL multimers. CONCLUSIONS: Pregnant patients with a history of TTP must be followed in a tertiary obstetric unit with plasmapheresis available. Influence of vWF-cleaving protease and vWF multimeric abnormalities on TTP relapsing during pregnancy has to be evaluated in a further multicentre study.
BACKGROUND:Thrombotic thrombocytopenic purpura (TTP) is a rare cause of severe thrombocytopenia in pregnancy. METHODS: Six pregnancies in five patients with TTP were followed prospectively over 5 years. Ultralarge von Willebrand factor (ULvWF) multimers and cleaving protease (cp) levels were measured. RESULTS: TTP relapsed, complicating four of the six pregnancies. Of three patients who relapsed, two had complete or partial vWF-cleaving protease (vWF-cp) deficiency, and one had a normal vWF-cleaving protease level. In all three we found abnormal UL multimers. The two women who did not relapse had normal vWF-cleaving protease level and an absence or loss of UL multimers. CONCLUSIONS: Pregnant patients with a history of TTP must be followed in a tertiary obstetric unit with plasmapheresis available. Influence of vWF-cleaving protease and vWF multimeric abnormalities on TTP relapsing during pregnancy has to be evaluated in a further multicentre study.
Authors: Yang Jiang; Jennifer J McIntosh; Jessica A Reese; Cassandra C Deford; Johanna A Kremer Hovinga; Bernhard Lämmle; Deirdra R Terrell; Sara K Vesely; Eric J Knudtson; James N George Journal: Blood Date: 2014-01-07 Impact factor: 22.113
Authors: Fadi Fakhouri; Lubka Roumenina; François Provot; Marion Sallée; Sophie Caillard; Lionel Couzi; Marie Essig; David Ribes; Marie-Agnès Dragon-Durey; Frank Bridoux; Eric Rondeau; Veronique Frémeaux-Bacchi Journal: J Am Soc Nephrol Date: 2010-03-04 Impact factor: 10.121
Authors: Jenna Brown; Bindu Potugari; Marshall A Mazepa; Ruhail Kohli; Alison R Moliterno; Robert A Brodsky; Jason A Vaught; Richard Burwick; Shruti Chaturvedi Journal: Ann Hematol Date: 2022-08-06 Impact factor: 4.030
Authors: Wan Suriana Wan Ab Rahman; Wan Zaidah Abdullah; Rapiaah Mustaffa; Suhair Abbas Ahmed; Mohd Nazri Hassan; Azlan Husin Journal: Clin Med Insights Case Rep Date: 2013-09-15