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A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy

Thrombocytopenic purpura (TTP) is a rare, potentially fatal pathology characterized by microangiopathic thrombotic syndrome and caused by an acute protease deficiency of von Willebrand factor, ADAMTS13. Moreover, ADAMTS13 deficiency promotes microthrombosis led by the persistence of ultra-large VWF...

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Autores principales: Mitranovici, Melinda Ildiko, Pușcașiu, Lucian, Oală, Ioan Emilian, Petre, Izabella, Craina, Marius Lucian, Mager, Antonia Rebeka, Vasile, Kinga, Chiorean, Diana Maria, Sabău, Adrian-Horațiu, Turdean, Sabin Gligore, Cotoi, Ovidiu Simion
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323862/
https://www.ncbi.nlm.nih.gov/pubmed/35885465
http://dx.doi.org/10.3390/diagnostics12071559
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author Mitranovici, Melinda Ildiko
Pușcașiu, Lucian
Oală, Ioan Emilian
Petre, Izabella
Craina, Marius Lucian
Mager, Antonia Rebeka
Vasile, Kinga
Chiorean, Diana Maria
Sabău, Adrian-Horațiu
Turdean, Sabin Gligore
Cotoi, Ovidiu Simion
author_facet Mitranovici, Melinda Ildiko
Pușcașiu, Lucian
Oală, Ioan Emilian
Petre, Izabella
Craina, Marius Lucian
Mager, Antonia Rebeka
Vasile, Kinga
Chiorean, Diana Maria
Sabău, Adrian-Horațiu
Turdean, Sabin Gligore
Cotoi, Ovidiu Simion
author_sort Mitranovici, Melinda Ildiko
collection PubMed
description Thrombocytopenic purpura (TTP) is a rare, potentially fatal pathology characterized by microangiopathic thrombotic syndrome and caused by an acute protease deficiency of von Willebrand factor, ADAMTS13. Moreover, ADAMTS13 deficiency promotes microthrombosis led by the persistence of ultra-large VWF multimers in the blood circulation. According to the few studies involving pregnant participants, the heterogeneity of manifestations has made this pathology difficult to diagnose, with an unexpected occurrence and increased risk of maternal and fetal morbidity and mortality. We reported on the case of a 28-year-old pregnant woman with an obstetric score of G2P0 who presented to the obstetrics and gynecology department of our clinic with the complaint of minimal vaginal bleeding. The evolution of our case was severe and life-threatening, a “race against the clock”, with our goal being to emphasize the importance and difficulty of diagnosing TTP in the absence of specific symptomatology. We faced a lack of technological support for a correct and complete diagnosis, and the first manifestation of this disease was the intrauterine death of the fetus. After completing all the necessary procedures, the placental tissue was sent for further histopathological evaluation. We highlighted the importance of monitoring ADAMTS13 for relapses monthly, with prophylaxis being essential for maternal and fetal mortality and morbidity.
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spelling pubmed-93238622022-07-27 A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy Mitranovici, Melinda Ildiko Pușcașiu, Lucian Oală, Ioan Emilian Petre, Izabella Craina, Marius Lucian Mager, Antonia Rebeka Vasile, Kinga Chiorean, Diana Maria Sabău, Adrian-Horațiu Turdean, Sabin Gligore Cotoi, Ovidiu Simion Diagnostics (Basel) Case Report Thrombocytopenic purpura (TTP) is a rare, potentially fatal pathology characterized by microangiopathic thrombotic syndrome and caused by an acute protease deficiency of von Willebrand factor, ADAMTS13. Moreover, ADAMTS13 deficiency promotes microthrombosis led by the persistence of ultra-large VWF multimers in the blood circulation. According to the few studies involving pregnant participants, the heterogeneity of manifestations has made this pathology difficult to diagnose, with an unexpected occurrence and increased risk of maternal and fetal morbidity and mortality. We reported on the case of a 28-year-old pregnant woman with an obstetric score of G2P0 who presented to the obstetrics and gynecology department of our clinic with the complaint of minimal vaginal bleeding. The evolution of our case was severe and life-threatening, a “race against the clock”, with our goal being to emphasize the importance and difficulty of diagnosing TTP in the absence of specific symptomatology. We faced a lack of technological support for a correct and complete diagnosis, and the first manifestation of this disease was the intrauterine death of the fetus. After completing all the necessary procedures, the placental tissue was sent for further histopathological evaluation. We highlighted the importance of monitoring ADAMTS13 for relapses monthly, with prophylaxis being essential for maternal and fetal mortality and morbidity. MDPI 2022-06-27 /pmc/articles/PMC9323862/ /pubmed/35885465 http://dx.doi.org/10.3390/diagnostics12071559 Text en © 2022 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 Case Report
Mitranovici, Melinda Ildiko
Pușcașiu, Lucian
Oală, Ioan Emilian
Petre, Izabella
Craina, Marius Lucian
Mager, Antonia Rebeka
Vasile, Kinga
Chiorean, Diana Maria
Sabău, Adrian-Horațiu
Turdean, Sabin Gligore
Cotoi, Ovidiu Simion
A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
title A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
title_full A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
title_fullStr A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
title_full_unstemmed A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
title_short A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
title_sort race against the clock: a case report and literature review concerning the importance of adamts13 testing in diagnosis and management of thrombotic thrombocytopenic purpura during pregnancy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323862/
https://www.ncbi.nlm.nih.gov/pubmed/35885465
http://dx.doi.org/10.3390/diagnostics12071559
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