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Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review

Thrombotic microangiopathy can present itself in the form of several clinical entities, representing a real challenge for diagnosis and treatment in pediatric practice. Our article aims to explore the evolution of two rare cases of pediatric thrombotic thrombocytopenic purpura (TTP) and atypical hem...

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Autores principales: Mocanu, Adriana, Bogos, Roxana Alexandra, Lazaruc, Tudor Ilie, Cianga, Anca Lavinia, Lupu, Vasile Valeriu, Ioniuc, Ileana, Alecsa, Mirabela, Lupu, Ancuta, Ivanov, Anca Viorica, Miron, Ingrith Crenguta, Starcea, Iuliana Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10093431/
https://www.ncbi.nlm.nih.gov/pubmed/37046448
http://dx.doi.org/10.3390/diagnostics13071228
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author Mocanu, Adriana
Bogos, Roxana Alexandra
Lazaruc, Tudor Ilie
Cianga, Anca Lavinia
Lupu, Vasile Valeriu
Ioniuc, Ileana
Alecsa, Mirabela
Lupu, Ancuta
Ivanov, Anca Viorica
Miron, Ingrith Crenguta
Starcea, Iuliana Magdalena
author_facet Mocanu, Adriana
Bogos, Roxana Alexandra
Lazaruc, Tudor Ilie
Cianga, Anca Lavinia
Lupu, Vasile Valeriu
Ioniuc, Ileana
Alecsa, Mirabela
Lupu, Ancuta
Ivanov, Anca Viorica
Miron, Ingrith Crenguta
Starcea, Iuliana Magdalena
author_sort Mocanu, Adriana
collection PubMed
description Thrombotic microangiopathy can present itself in the form of several clinical entities, representing a real challenge for diagnosis and treatment in pediatric practice. Our article aims to explore the evolution of two rare cases of pediatric thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS) with extremely similar clinical pictures, which, coincidentally, presented at approximately the same time in our hospital. These cases and our literature review demonstrate the multiple facets of thrombotic microangiopathy, which can produce various determinations and salient manifestations even among the pediatric population. TTP and aHUS may represent genuine diagnostic pitfalls through the overlap of their clinical and biological findings, although they develop through fundamentally different mechanisms that require different therapeutic approaches. As a novelty, we underline that COVID-19 infection cannot be excluded as potential trigger for TTP and aHUS in our patients and we predict that other reports of such an association will follow, raising a complex question of COVID-19’s implication in the occurrence and evolution of thrombotic microangiopathies. On this matter, we conducted literature research that resulted in 15 cases of COVID-19 pediatric infections associated with either TTP or aHUS. Taking into consideration the morbidity associated with TTP and aHUS, an elaborate differential diagnosis and prompt intervention are of the essence.
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spelling pubmed-100934312023-04-13 Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review Mocanu, Adriana Bogos, Roxana Alexandra Lazaruc, Tudor Ilie Cianga, Anca Lavinia Lupu, Vasile Valeriu Ioniuc, Ileana Alecsa, Mirabela Lupu, Ancuta Ivanov, Anca Viorica Miron, Ingrith Crenguta Starcea, Iuliana Magdalena Diagnostics (Basel) Review Thrombotic microangiopathy can present itself in the form of several clinical entities, representing a real challenge for diagnosis and treatment in pediatric practice. Our article aims to explore the evolution of two rare cases of pediatric thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS) with extremely similar clinical pictures, which, coincidentally, presented at approximately the same time in our hospital. These cases and our literature review demonstrate the multiple facets of thrombotic microangiopathy, which can produce various determinations and salient manifestations even among the pediatric population. TTP and aHUS may represent genuine diagnostic pitfalls through the overlap of their clinical and biological findings, although they develop through fundamentally different mechanisms that require different therapeutic approaches. As a novelty, we underline that COVID-19 infection cannot be excluded as potential trigger for TTP and aHUS in our patients and we predict that other reports of such an association will follow, raising a complex question of COVID-19’s implication in the occurrence and evolution of thrombotic microangiopathies. On this matter, we conducted literature research that resulted in 15 cases of COVID-19 pediatric infections associated with either TTP or aHUS. Taking into consideration the morbidity associated with TTP and aHUS, an elaborate differential diagnosis and prompt intervention are of the essence. MDPI 2023-03-24 /pmc/articles/PMC10093431/ /pubmed/37046448 http://dx.doi.org/10.3390/diagnostics13071228 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mocanu, Adriana
Bogos, Roxana Alexandra
Lazaruc, Tudor Ilie
Cianga, Anca Lavinia
Lupu, Vasile Valeriu
Ioniuc, Ileana
Alecsa, Mirabela
Lupu, Ancuta
Ivanov, Anca Viorica
Miron, Ingrith Crenguta
Starcea, Iuliana Magdalena
Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review
title Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review
title_full Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review
title_fullStr Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review
title_full_unstemmed Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review
title_short Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review
title_sort pitfalls of thrombotic microangiopathies in children: two case reports and literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10093431/
https://www.ncbi.nlm.nih.gov/pubmed/37046448
http://dx.doi.org/10.3390/diagnostics13071228
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