
Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Thrombotic thrombocytopenic purpura is a rare type of microangiopathic hemolytic anemia caused by a defciency of ADAMTS 13 protein whose mortality without treatment is 90%. In our hospital we cannot quantify this protein. Diagnostic should be strongly suspected in the presence of hemolytic anemia, thrombocytopenia and peripheral blood schistocytes. We describe 3 cases, the frst of a 52 years with idiopathic acquired TTP requiring plasma exchange and steroids without good response. Given the refractoriness was necessary administration of Rituximab, Cyclophosphamide and Vincristine. The second case, a 42 year old female patient with Anti DNA antibody positivity develops a PTT with impairment of consciousness, hemiparesis and seizures that required treatment in intensive care, after 5 sessions of plasmapheresis and steroids had a favorable outcome. The third case, 45 years old male patient who presents with dyspnea, diagnosis of TTP is documented by abundant Schistocytes in peripheral blood, develops secondary acute respiratory failure and died. At autopsy is was found a massive right ventricular infarction. We consider a contribution to the literature this description of cases especially by heterogeneity of presentation and response to treatment.
George J. Thrombotic Thrombocytopenic Purpura. N Engl J Med 2006;354:1927-35
Scully, M. Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies. Br J Haematol. 2012 aug;158(3):323-35
George JN, Al-Nouri ZL. Diagnostic and therapeutic challenges in the thrombotic thrombocytopenic purpura and hemolytic uremic syndromes. Hematology Am Soc Hematol Educ Program. 2012;2012:604-9
Sadler JE, Moake JL, Miyata T, George JN. Recent advances in thrombotic thrombocytopenic purpura. In: Broud VC, Berliner N, Larson RA, Leung LLK,eds. Hematology 2004. Washington, D.C.: American Society of Hematology, 2004: 407-23
George, J. How I treat patients with thrombotic thrombocytopenic purpura hemolytic uremic syndrome. Blood. 2000; 96:1223-1229
George, J. Syndromes of Thrombotic Microangiopathy. N Engl J Med 2014;371:654-66
Cruz Hernández V, León Tapia S, Santos Blas Y, Pérez Campos E. Púrpura trombocitopénica trombótica resistente; tratamiento con rituximab. Med Int Méx 2014;30:496-501
Rose, Michal, and Amiram Eldor. High incidence of relapses in thrombotic thrombocytopenic purpura: clinical study of 38 patients.The American journal of medicine 1987, 83.3: 437-444
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