Acute pancreatitis induced thrombotic thrombocytopenic purpura

Ali, Mohammed Arshad; Shaheen, Jalal Syed Shafiuddin; Khan, Mohammed

doi:10.4103/0972-5229.126084

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…Thrombotic thrombocytopenic purpura (TTP) is a rare acquired or congenital disorder with an annual incidence of six cases per million (1). Its pathogenesis involves an imbalance between von Willebrand factor (vWF) multimers and ADAMTS13.…”

Section: Discussionmentioning

confidence: 99%

“…The etiology is found in only 10% of cases. It has been associated with pregnancy, vascular disease, malignancy, and certain drugs, and the newest associations are HIV and pancreatitis (1). Case reports have shown TTP-aHUS secondary to autoimmune pancreatitis, alcohol abuse, gallstones, and granulomatous pancreatic inflammation due to sarcoid.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism in TTP-induced pancreatitis is not well understood but is proposed to be pancreatic tissue damage occurring as a result of intracellular activation of enzymes leading to a secondary inflammatory response and release of cytokines (1). In case of TTP occurring after pancreatitis, it is plausible that the widespread immunological response as a result of pancreatitis may be involved.…”

Section: Discussionmentioning

confidence: 99%

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Eculizumab refractory thrombotic thrombocytopenic purpura secondary to post-endoscopic retrograde cholangiopancreatography pancreatitis in a patient

Malik

Ali

Ahsan

et al. 2016

Journal of Community Hospital Internal Medicine Perspectives

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Thrombotic thrombocytopenic purpura (TTP) is a rare multisystem microvascular disorder, which is characterized by pentad of thrombocytopenia, microangiopathic hemolytic anemia, and organ dysfunction due to occlusive thrombi. The proposed pathophysiology involves an imbalance between unusually large von Willebrand factor multimers and the cleaving protease ADAMTS13. Acute pancreatitis is a well-described consequence of TTP, but TTP secondary to acute pancreatitis is a rare phenomenon. We present a patient who developed TTP due to post-ERCP pancreatitis with hematologic, cardiovascular, pulmonary, and renal complications and is the first case of this kind. Despite early initiation of therapy, the patient did not recover making it among the 10% of cases of TTP that prove fatal despite appropriate therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Eculizumab refractory thrombotic thrombocytopenic purpura secondary to post-endoscopic retrograde cholangiopancreatography pancreatitis in a patient

Malik

Ali

Ahsan

et al. 2016

Journal of Community Hospital Internal Medicine Perspectives

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“…Today it is recognized as a rare disorder, with an annual incidence of around 6 per million. [ 2 ] TTP has multiple and diverse etiologies, manifestations, associated conditions, and risk factors. This disease has a characteristic pentad of symptoms: microangiopathic hemolytic anemia (MAHA), neurologic changes, fever, thrombocytopenia, and renal dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…TTP can be congenital (deficiency of ADAMTS13) or acquired. To the best of our knowledge, there are only a few case reports published describing the rare phenomenon of TTP induced by pancreatitis [ 2 , 4 – 10 ]. Swisher [ 9 ] reported that the expected incidence of coincidental occurrence of TTP and pancreatitis in the same year is 3.75 per 10 9 population.…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Thrombotic Thrombocytopenic Purpura Caused by Pancreatitis and Clopidogrel

et al. 2018

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Patient: Male, 71Final Diagnosis: Thrombotic thrombocytopenic purpuraSymptoms: Abdominal and/or epigastric painMedication: —Clinical Procedure: —Specialty: General and Internal MedicineObjective:Rare co-existance of disease or pathologyBackground:Thrombotic thrombocytopenic purpura is mostly characterized by symptoms and signs of hemolytic anemia, thrombocytopenia, renal impairment, fever and neurologic dysfunction. It is not always necessary to have all 5 characteristic symptoms, and presentations can vary. It can be congenital or acquired by any etiology that causes deficiency or dysfunction of ADAMST13 enzyme.Case Report:We present a case of a 71-year-old man who presented to our hospital initially with abdominal pain. He was diagnosed with pancreatitis, and conservative management was started with pain control and hydration. During the hospital course, the patient developed anemia that was hemolytic in nature, acute kidney injury and thrombocytopenia. He was then diagnosed as having TTP secondary to pancreatitis with additive effect of clopidogrel, as he had recently been started on clopidogrel due to percutaneous coronary intervention. He was started on prompt treatment with plasma exchange and intermittent dialysis, and he achieved full recovery after that.Conclusions:TTP is a potentially fatal disease with high mortality risk. It is judicious to recognize and have high suspicion of TTP being caused by such rare causes (pancreatitis and clopidogrel), as immediate recognition and treatment can enhance survival.

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A rare manifestation presenting as acute pancreatitis of thrombotic thrombocytopenic purpura

Wang,

Wang

2024

Adv in Digestive Medicine

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Thrombotic thrombocytopenic purpura (TTP) is an unusual disease with a 90% mortality rate without prompt management. The typical clinical manifestations include thrombocytopenia, hemolytic anemia, neurological symptoms, fever, and renal impairment. However, recognizing TTP in its early stages is not always easy due to limited clinical experience and sometimes atypical presentation. We report a 44‐year‐old male who initially suffered from jaundice and skin purpura, followed by epigastric pain. Acute pancreatitis was first suspected after a computerized tomography (CT) scan in the local medical department, without a definite etiology. He was then transferred to our hospital for further investigation of hemolysis. Transient neurological symptoms occurred 1 week after transferring. TTP was later confirmed based on schistocytes noted in peripheral blood smear and ADAMTS‐13 activity = 0%. The patient was discharged successfully after prompt therapeutic plasma exchange and steroid treatment. We present the first case of TTP inducing acute pancreatitis in Asia and remind that acute pancreatitis is a possible cause of abdominal pain, although it's a rare manifestation of TTP.

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Acute pancreatitis induced thrombotic thrombocytopenic purpura

Cited by 15 publications

References 7 publications

Eculizumab refractory thrombotic thrombocytopenic purpura secondary to post-endoscopic retrograde cholangiopancreatography pancreatitis in a patient

Eculizumab refractory thrombotic thrombocytopenic purpura secondary to post-endoscopic retrograde cholangiopancreatography pancreatitis in a patient

A Rare Case of Thrombotic Thrombocytopenic Purpura Caused by Pancreatitis and Clopidogrel

A rare manifestation presenting as acute pancreatitis of thrombotic thrombocytopenic purpura

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