Abstract
We are presenting a case of TTP with undetectable levels of ADAMTS 13 in a 39-year-old woman. Diagnosis of systemic lupus was evoked in the setting of thrombotic microangiopathy. The patient presented normal renal function but important neurological impairment. Treatment with daily plasmapheresis as well as Rituximab, cyclophosphamide as steroids was required to achieve clinical improvement.
Similar content being viewed by others
References
Hamasaki K, Mimura T, Kanda H, Kubo K, Setoguchi K, Satoh T, Misaki Y, Yamamoto K. Systemic lupus erythematosus and thrombotic thrombocytopenic purpura: a case report and literature review. Clin Rheumatol. 2003;22:355–8.
Lim W, Vesely SK, George JN. The role of rituximab in the management of patients with acquired thrombotic thrombocytopenic purpura. Blood. 2015;125(10):1526–31.
Pagalavan L, Ng H-J, Lee L-H, et al. A comparison of thrombotic thrombocytopenic purpura in an inception cohort of patients with and without systemic lupus erythematosus. Rheumatology. 2009;48:399–403.
Nguyen L, Li X, Duvall D, Terrell DR, Vesely SK, George JN. Twice-daily plasma exchange for patients with refractory thrombotic thrombocytopenic purpura: the experience of the Oklahoma Registry, 1989 through 2006. Transfusion. 2008;48(2):349.
Garcia BR, Mas EE, Mas EM, et al. Lupus eritematoso sistémico y púrpura trombótica trombocitopénica: un caso refractario sin actividad lúpica asociada. Reumatol Clin. 2013;9(6):373–5.
De la Rubia J, Contreras E, Del Río-Garma J. Púrpura trombótica trombocitopénica. Med Clin (Barc). 2011;136:534–40.
Evan Sadler J. Thrombotic thrombocytopenic purpura: a moving target. Haematology. 2006:415–20.
Peyvandi F, Palla R, Lotta LA. Pathogenesis and treatment of adquired idiopatic thrombotic thrombocytopenic purpura. Haematologica. 2010;95:1444–7.
Fujimura Y, Matsumoto M. Registry of 919 patients with thrombotic microangiopathies across Japan: database of Nara Medical University during 1998-2008. Int Med. 2010;49:7–15.
Letchumannan P, Ng HJ, Lee LH, Thumboo J. A comparison of thrombotic thrombocytopenic purpura in an inception cohort of patients with and without systemic lupus erythematosus. Rheumatology. 2009;48:399–403.
Devinski O, Petito CK, Alonso DR. Clinical and neuropathological findings in systemic lupus erythematosus: the role of vasculitis, heart emboli and thrombotic thrombocytopenic purpura. Ann Neurol. 1988;23:380–4.
Allford SL, Hunt BJ, Rose P, Machin SJ. Guidelines on the diagnosis and management of the thrombotic microangiopathic haemolytic anaemias. Br J Haematol. 2003;120:556–73.
Aamer A, Saleh AS. Thrombotic thrombocytopenic purpura associated with systemic lupus erythematosus. Acta Haem. 2006;115:68–73.
Cameron JS. Lupus nephritis. J Am Soc Nephrol. 1999;10:413–24.
Song D, Wu L-h, Wang F-m, et al. The spectrum of renal thrombotic microangiopathy in lupus nephritis. Arthritis Research & Therapy. 2013;15:R12.
Nesher G, Hanna VE, Moore TL, Hersh M, Osborn TG. Thrombotic microangiopathic hemolytic anaemia in systemic lupus erythematosus. Semin Arthritis Rheum. 1994;24:165–72.
George JN, Cuker A. Acquired TTP: initial treatment. Feb. 12,2016 UpToDate.
George JN, Cuker A. Acquired TTP: treatment of refractory or relapsed disease. Feb. 12,2016 UpToDate.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
González, N.S., Lorenzo, N., Parodis, Y. et al. Thrombotic thrombocytopenic purpura in a new onset lupus patient?. Immunol Res 65, 454–458 (2017). https://doi.org/10.1007/s12026-017-8898-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12026-017-8898-y