T Falter1, K J Alber, I Scharrer. 1. III. Medizinische Klinik, Universitätsmedizin Mainz, Langenbeckstraße 1, Mainz, Germany.
Abstract
UNLABELLED: We report on 21 patients with idiopathic thrombotic thrombocytopenic purpura (TTP) whose courses of disease have been followed from the respective diagnosis until now. They had a documented ADAMTS13 activity below 5%, a high autoantibody titer and detectable ultralarge von Willebrand factor (VWF) multimers during their episodes. The initial diagnosis was based on clinical symptoms and on laboratory parameters: thrombocytopenia, haemolytic anaemia, schistocytes and an increased LDH level. 103 acute clinical episodes of 21 TTP-patients during a time period of 30 years are described. Case histories, comorbidities and sequelae were retrospectively documented. RESULTS, CONCLUSION: Although patients are consistently in a prothrombotic status, clinical acute manifestations only occur after triggering. Most common trigger factors are gastrointestinal infections and pregnancy. The relapse risk per month is 0.026; men have a higher risk for relapses (0.044) than women (0.021). Patients recover physically well, except for renal insufficiency in four cases. Nevertheless, major portion of patients suffers persistently from depression, anxiety disorders and persistent neurocognitive impairments.
UNLABELLED: We report on 21 patients with idiopathic thrombotic thrombocytopenic purpura (TTP) whose courses of disease have been followed from the respective diagnosis until now. They had a documented ADAMTS13 activity below 5%, a high autoantibody titer and detectable ultralarge von Willebrand factor (VWF) multimers during their episodes. The initial diagnosis was based on clinical symptoms and on laboratory parameters: thrombocytopenia, haemolytic anaemia, schistocytes and an increased LDH level. 103 acute clinical episodes of 21 TTP-patients during a time period of 30 years are described. Case histories, comorbidities and sequelae were retrospectively documented. RESULTS, CONCLUSION: Although patients are consistently in a prothrombotic status, clinical acute manifestations only occur after triggering. Most common trigger factors are gastrointestinal infections and pregnancy. The relapse risk per month is 0.026; men have a higher risk for relapses (0.044) than women (0.021). Patients recover physically well, except for renal insufficiency in four cases. Nevertheless, major portion of patients suffers persistently from depression, anxiety disorders and persistent neurocognitive impairments.
Authors: Jingrui Sui; Wenjing Cao; Konstantine Halkidis; Mohammad S Abdelgawwad; Nicole K Kocher; Bryan Guillory; Lance A Williams; Radhika Gangaraju; Marisa B Marques; X Long Zheng Journal: Blood Adv Date: 2019-12-23
Authors: Wolfgang Miesbach; Jan Menne; Martin Bommer; Ulf Schönermarck; Thorsten Feldkamp; Martin Nitschke; Timm H Westhoff; Felix S Seibert; Rainer Woitas; Rui Sousa; Michael Wolf; Stefan Walzer; Björn Schwander Journal: Orphanet J Rare Dis Date: 2019-11-15 Impact factor: 4.123