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In a case report, a woman in her 40s developed peripheral hypothyroidism and a woman in her 20s developed subclinical hypothyroidism during treatment with rituximab for thrombotic thrombocytopenic purpura (TTP) and thiamazole for Graves' disease (GD) [not all routes stated].
Patient 1: A woman in her 40s developed subclinical hypothyroidism during treatment with rituximab and thiamazole. The woman was diagnosed with TTP at the age of 40 years, despite a negative test for anti-ADAMTS13 antibodies. She made a quick recovery with unspecified steroids and daily plasma exchange using fresh frozen plasma as a substitution fluid. However, one week later, she experienced a severe TTP relapse with microangiopathic involvement of the brain, heart, lung, kidneys, liver, spleen, stomach and gut. She received plasma exchange twice daily and had received 41 exchanges over a six-week period. Additionally, she received two 1g infusions of rituximab. She made a complete recovery and ADAMTS13 activity...
- Lhotta K, et al. Treatment of Concurrent Thrombotic Thrombocytopenic Purpura and Graves' Disease: A Report on Two Cases. Case Reports in Endocrinology 2018: Jan 2018. Available from: URL: http://doi.org/10.1155/2018/5747969 - Austria