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Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report
BACKGROUND: Acute thrombotic thrombocytopenic purpura (TTP) is an aggressive thrombotic microangiopathy that if not treated, can have a 90% mortality rate. Timely, extensive plasma exchange (PEX) has been indicated to reduce the mortality rate to < 10%, but its side effects are not well-known. We...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935836/ https://www.ncbi.nlm.nih.gov/pubmed/35313908 http://dx.doi.org/10.1186/s13019-022-01789-8 |
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author | Zhou, Mi Yin, Jie |
author_facet | Zhou, Mi Yin, Jie |
author_sort | Zhou, Mi |
collection | PubMed |
description | BACKGROUND: Acute thrombotic thrombocytopenic purpura (TTP) is an aggressive thrombotic microangiopathy that if not treated, can have a 90% mortality rate. Timely, extensive plasma exchange (PEX) has been indicated to reduce the mortality rate to < 10%, but its side effects are not well-known. We present here a case of a patient presented with Comb (+) TTP and developed catheter-associated deep vein thrombosis (DVT). CASE PRESENTATION: A 27-year-young man presented with persistent thrombocytopenia and Coombs positive anemia was firstly diagnosed with Evans syndrome. However, he was refractory to a methylprednisolone pulse therapy with a combination of platelet transfusion and eventually developed microangiopathy of central nerve system. Several pathological manifestations of the disease were prevented by PEX. The immediate start of PEX (1500 mL/d) induced a complete remission of acquired TTP and disappearance of neurological signs and symptoms. However, external iliac and femoro-popliteal venous thrombosis was diagnosed subsequently, inferior vena cava filter (IVC) filter was immediately implanted accompanied with anticoagulation therapy. Meanwhile, PEX session was sustained as well as oral anticoagulant (rivaroxaban). 14 days later, the patient got full recovery. CONCLUSIONS: Catheter-related DVT under the setting of TTP should be cautious. It is necessary to start anticoagulation and antiplatelet therapy for thrombosis early, especially in such cases when PLT count > 50 × 10(9)/L. |
format | Online Article Text |
id | pubmed-8935836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89358362022-03-23 Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report Zhou, Mi Yin, Jie J Cardiothorac Surg Case Report BACKGROUND: Acute thrombotic thrombocytopenic purpura (TTP) is an aggressive thrombotic microangiopathy that if not treated, can have a 90% mortality rate. Timely, extensive plasma exchange (PEX) has been indicated to reduce the mortality rate to < 10%, but its side effects are not well-known. We present here a case of a patient presented with Comb (+) TTP and developed catheter-associated deep vein thrombosis (DVT). CASE PRESENTATION: A 27-year-young man presented with persistent thrombocytopenia and Coombs positive anemia was firstly diagnosed with Evans syndrome. However, he was refractory to a methylprednisolone pulse therapy with a combination of platelet transfusion and eventually developed microangiopathy of central nerve system. Several pathological manifestations of the disease were prevented by PEX. The immediate start of PEX (1500 mL/d) induced a complete remission of acquired TTP and disappearance of neurological signs and symptoms. However, external iliac and femoro-popliteal venous thrombosis was diagnosed subsequently, inferior vena cava filter (IVC) filter was immediately implanted accompanied with anticoagulation therapy. Meanwhile, PEX session was sustained as well as oral anticoagulant (rivaroxaban). 14 days later, the patient got full recovery. CONCLUSIONS: Catheter-related DVT under the setting of TTP should be cautious. It is necessary to start anticoagulation and antiplatelet therapy for thrombosis early, especially in such cases when PLT count > 50 × 10(9)/L. BioMed Central 2022-03-21 /pmc/articles/PMC8935836/ /pubmed/35313908 http://dx.doi.org/10.1186/s13019-022-01789-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Zhou, Mi Yin, Jie Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report |
title | Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report |
title_full | Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report |
title_fullStr | Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report |
title_full_unstemmed | Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report |
title_short | Complete recovery of deep venous thrombosis from Coombs (+) thrombotic thrombocytopenic purpura: case report |
title_sort | complete recovery of deep venous thrombosis from coombs (+) thrombotic thrombocytopenic purpura: case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935836/ https://www.ncbi.nlm.nih.gov/pubmed/35313908 http://dx.doi.org/10.1186/s13019-022-01789-8 |
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