Postpartum thrombotic thrombocytopenic purpura

Gill Hong Sun,; Chi Young Park,; Choon Hae Chung,

Korean J Med > Volume 69(3); 2005 > Article

Original Article

The Korean Journal of Medicine 2005;69(3):939-942.

Postpartum thrombotic thrombocytopenic purpura

Gill Hong Sun, Chi Young Park, Choon Hae Chung

이화여자대학교 의과대학 내과학 교실, 의과학 연구소

증례 : 산후 혈전성 혈소판 감소성 자반증

선길홍&#;박치영&#;정춘해, Chi Young Park, Choon Hae Chung

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a life threatening disease, characterized by Moschcowitz's pentad: thrombocytopenia, microangiopathic hemolytic anemia, fluctuating neurological signs, renal failure, and fever. Plasma exchange is the essential therapy for TTP, dramatically improving survival from less than 10% to approximately 80%. However, the decision to initiate plasma exchange is difficult in women during pregnancy or immediately postpartum, because preeclampsia, eclampsia, and HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome can have all of the clinical features of TTP. The decision to intervene with plasma exchange treatment is based upon the severity of thrombocytopenia, microangiopathic hemolytic anemia, neurologic signs, and renal failure, the course of these abnormalities following delivery, and evaluation of ADAMTS-13 activity. We experienced a case of TTP coexisted with preeclampsia, so we report it with a brief review of literature.(Korean J Med 69:S939-S942, 2005)

Key Words: Thrombotic thrombocytopenic purpura, Plasma exchange, Preeclampsia