COVID-19-Associated Thrombotic Thrombocytopenic Purpura: A Case Report and Systematic Review

Chaudhary, Haseeb; Nasir, Usama; Syed, Khezar; Labra, Maria; Reggio, Christopher; Aziz, Ansar; Shah, P.; Reddy, Rajesh; Sangha, Navdeep

doi:10.3390/hematolrep14030035

Cited by 10 publications

(19 citation statements)

References 26 publications

(40 reference statements)

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“…Since the outbreak of COVID-19 in 2019, several cases of aHUS and TTP have been reported [9,10] , the mechanism by which COVID-19 induces TMA remains unclear. Coagulation activation is common in patients with severe COVID-19, and coagulation biomarkers including FVIII and VWF are independent predictors of increased oxygen requirement in COVID-19 patients [11,12] .…”

Section: Discussionmentioning

confidence: 99%

AHUS mistaken for TTP associated with COVID-19: a case report

Wang

Cong

et al. 2023

Preprint

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Thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS) are both thrombotic microangiopathies that share several clinical traits including microangiopathic hemolytic anemia, thrombocytopenia, and organic damage. There is inherent opportunity for misdiagnosis. As thrombocytopenia and thrombus are strongly related to COVID-19, it may be more difficult to tell an aHUS from a TTP when COVID-19 is present. Thus, we describe a patient presenting with severe COVID-19 who was misdiagnosed with TTP but in the end corrected to aHUS. We suggest that perform detection to ADAMTS-13 activity and complement gene mutation as soon as possible is necessary.

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Section: Discussionmentioning

confidence: 99%

AHUS mistaken for TTP associated with COVID-19: a case report

Wang

Cong

et al. 2023

Preprint

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“…Additionally, ADAMTS13 levels fall as a result of COVID-19 inflammation, according to small-scale research. A systematic review was done on COVID-19 and its association with TTP, which were unrelated to its severity [ 7 ]. Unlike earlier investigations, we found TTP in people who had no history of haematological illness.…”

Section: Discussionmentioning

confidence: 99%

Thrombotic Thrombocytopenic Purpura Treated Successfully in a COVID-19 Patient Having a Computed Tomography Severity Score of 22/25

Pawar¹,

Saboo²,

Yelne³

et al. 2022

Cureus

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We present a case of a 50-year-old female who came to us with chief complaints of breathlessness, general weakness, and cough. She tested positive for coronavirus disease 2019 (COVID-19) on testing with Reverse Transcription Polymerase Chain Reaction (RT-PCR). She had high resolution computed tomography (HRCT) thorax score of 22/25. On investigation, she had thrombocytopenia with schistocytosis on the peripheral smear and evidence of acute kidney injury. She was diagnosed with thrombotic thrombocytopenic purpura (TTP) and was treated with oral prednisone, plasma exchange, and remdesivir. There was an improvement in clinical as well as biochemical parameters such as lactate dehydrogenase, haemoglobin, and platelet counts. This case report highlights TTP that may be a serious complication in COVID-19 patients, especially with a CT severity score of 22/25. Early diagnosis and intervention can lead to a positive outcome.

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“…Similarly, it is likely that in COVID-19, as in other infectious diseases, molecular mimicry, a hyperactive immune system, and the virus itself represents the triad of plausible causal auto-immune events [ 91 , 98 ]. Other auto-immune conditions related to hemostasis and associated with COVID-19 include ITP [ 99 , 100 , 101 ] and TTP [ 102 , 103 ]. In terms of the latter, a large body of data indicates that COVID-19 is often associated with ADAMTS13 deficiency [ 104 , 105 , 106 ]; however, this may often be due to exhaustion of ADAMTS13 reserves due to the associated elevated release of VWF, rather than any immune basis or TTP.…”

Section: Autoantibodies Interfering With Hemostasis In Covid-19 and A...mentioning

confidence: 99%

Autoimmune Diseases Affecting Hemostasis: A Narrative Review

Favaloro

Pasalic

Lippi

2022

IJMS

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Hemostasis reflects a homeostatic mechanism that aims to balance out pro-coagulant and anti-coagulant forces to maintain blood flow within the circulation. Simplistically, a relative excess of procoagulant forces can lead to thrombosis, and a relative excess of anticoagulant forces can lead to bleeding. There are a wide variety of congenital disorders associated with bleeding or thrombosis. In addition, there exist a vast array of autoimmune diseases that can also lead to either bleeding or thrombosis. For example, autoantibodies generated against clotting factors can lead to bleeding, of which acquired hemophilia A is the most common. As another example, autoimmune-mediated antibodies against phospholipids can generate a prothrombotic milieu in a condition known as antiphospholipid (antibody) syndrome (APS). Moreover, there exist various autoimmunity promoting environments that can lead to a variety of antibodies that affect hemostasis. Coronavirus disease 2019 (COVID-19) represents perhaps the contemporary example of such a state, with potential development of a kaleidoscope of such antibodies that primarily drive thrombosis, but may also lead to bleeding on rarer occasions. We provide here a narrative review to discuss the interaction between various autoimmune diseases and hemostasis.

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COVID-19-Associated Thrombotic Thrombocytopenic Purpura: A Case Report and Systematic Review

Cited by 10 publications

References 26 publications

AHUS mistaken for TTP associated with COVID-19: a case report

AHUS mistaken for TTP associated with COVID-19: a case report

Thrombotic Thrombocytopenic Purpura Treated Successfully in a COVID-19 Patient Having a Computed Tomography Severity Score of 22/25

Autoimmune Diseases Affecting Hemostasis: A Narrative Review

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