An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries

Moschcowitz, Eli

doi:10.1016/0002-9343(52)90022-3

Cited by 117 publications

(93 citation statements)

References 2 publications

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“…It was first described by Moschcowitz in 1925 [1]. Numerous drugs have been implicated in its etiology, the most common being quinine, cyclosporine, ticlopidine, clopidogrel, mitomycin C, bleomycin, cisplatin, gemcitabine and tacrolimus.…”

Section: Introductionmentioning

confidence: 99%

Moxifloxacin (Avelox) Induced Thrombotic Thrombocytopenic Purpura

Surana

Sardinas

Multz

2012

Case Reports in Medicine

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We report a case of a 66-year-old African-American female who presented with complaints of progressively worsening weakness, shortness of breath on minimal exertion, lethargy for the last few days, and short episodes of aphasia lasting 20–30 seconds. Prior to presentation, she was treated with two courses of moxifloxacin for sinusitis. Laboratory examination was remarkable for anemia and thrombocytopenia with elevated lactate dehydrogenase and no evidence of renal failure. Peripheral smear showed numerous schistocytes and she was diagnosed with thrombotic thrombocytopenic purpura. Moxifloxacin was identified as the offending agent. The patient was treated with prednisone and plasmapheresis. To the best of our knowledge, this is the first reported case of thrombotic thrombocytopenic purpura associated with the use of moxifloxacin. Although rare, physicians should be aware of this serious complication associated with its use.

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Section: Introductionmentioning

confidence: 99%

Moxifloxacin (Avelox) Induced Thrombotic Thrombocytopenic Purpura

Surana

Sardinas

Multz

2012

Case Reports in Medicine

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“…Dear Sir, Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disease characterised by acute episodes of thrombocytopenia, microangiopatic haemolytic anaemia and disseminated thrombosis in the terminal arterioles and capillaries (Moschcowitz, 2003). TTP develops in patients with the severe deficiency of a disintegrin-like and metalloprotease with thrombospondin type 1 motif family (ADAMTS13), a circulating metalloprotease that cleaves the platelet-adhesive glycoprotein von Willebrand factor (VWF; George, 2006).…”

Section: Treatment Of Chronic Hepatitis C With Pegylated Interferon-αmentioning

confidence: 99%

Treatment of chronic hepatitis C with pegylated interferon‐α in a patient with recurrent autoimmune thrombotic thrombocytopenic purpura

Lotta

Degasperi

Aghemo

et al. 2012

Transfusion Medicine

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Treatment of chronic hepatitis C with pegylated interferon-α in a patient with recurrent autoimmune thrombotic thrombocytopenic purpuraDear Sir, Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disease characterised by acute episodes of thrombocytopenia, microangiopatic haemolytic anaemia and disseminated thrombosis in the terminal arterioles and capillaries (Moschcowitz, 2003). TTP develops in patients with the severe deficiency of a disintegrin-like and metalloprotease with thrombospondin type 1 motif family (ADAMTS13), a circulating metalloprotease that cleaves the platelet-adhesive glycoprotein von Willebrand factor (VWF; George, 2006). In patients with severely reduced ADAMTS13 activity, the accumulation of VWF multimers of ultra large size secreted by injured or activated endothelial cells is responsible for platelet aggregation and thrombosis (Moake, 2002). The cause of ADAMTS13 deficiency is usually the development of circulating auto-antibodies directed against the metalloprotease (Tsai and Lian, 1998;Sadler, 2008). Plasma exchange therapy is the cornerstone of TTP treatment, consisting of daily exchanges of one to two volumes of plasma until normalisation of laboratory values (George, 2006).Several studies reported cases of autoimmune TTP, which developed following pegylated interferon-α therapy for chronic hepatitis C virus (HCV) infection (

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“…Thrombotic thrombocytopenic purpura (TTP) is a rare hematological disorder, characterized by microangiopathic hemolytic anemia (MAHA) and thrombocytopenia, leading to end organ damage like fever, renal dysfunction, and neurological manifestations [1]. The pathogenesis of TTP involves deficiency of von Willebrand factor (vWF) cleaving metalloproteinase, known as ADAMTS13 [2–4].…”

Section: Introductionmentioning

confidence: 99%

Acquired Thrombotic Thrombocytopenic Purpura in a Patient with Pernicious Anemia

Pandey

Dahal

Fadlalla

et al. 2017

Case Reports in Hematology

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Introduction. Acquired thrombotic thrombocytopenic purpura (TTP) has been associated with different autoimmune disorders. However, its association with pernicious anemia is rarely reported. Case Report. A 46-year-old male presented with blood in sputum and urine for one day. The vitals were stable. The physical examination was significant for icterus. Lab tests' results revealed leukocytosis, macrocytic anemia, severe thrombocytopenia, renal dysfunction, and unconjugated hyperbilirubinemia. He had an elevated LDH, low haptoglobin levels with many schistocytes, nucleated RBCs, and reticulocytes on peripheral smear. Low ADAMTS13 activity (<10%) with elevated ADAMTS13 antibody clinched the diagnosis of severe acquired TTP, and plasmapheresis was started. There was an initial improvement in his hematological markers, which were however not sustained on discontinuation of plasmapheresis. For his refractory TTP, he was resumed on daily plasmapheresis and Rituximab was started. Furthermore, the initial serum Vitamin B12 and reticulocyte index were low in the presence of anti-intrinsic factor antibody. So with the concomitant diagnosis of pernicious anemia, Vitamin B12 was supplemented. The rest of the immunological workups were negative. Subsequently, his symptoms resolved and his hematological parameters improved. Discussion. While pernicious anemia can masquerade as TTP, an actual association between the two can also occur and needs further evaluation and characterization.

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An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries

Cited by 117 publications

References 2 publications

Moxifloxacin (Avelox) Induced Thrombotic Thrombocytopenic Purpura

Moxifloxacin (Avelox) Induced Thrombotic Thrombocytopenic Purpura

Treatment of chronic hepatitis C with pegylated interferon‐α in a patient with recurrent autoimmune thrombotic thrombocytopenic purpura

Acquired Thrombotic Thrombocytopenic Purpura in a Patient with Pernicious Anemia

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