Idiopathic Thrombocytopenic Purpura During Remission of Thrombotic Thrombocytopenic Purpura

Rs, Stein; Jm, Flexner

doi:10.1097/00007611-198412000-00034

Cited by 15 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TTP transformation to ITP has been described previously in the literature [4,5] as has their coexistence in a single patient with HIV [6], in post-partum states [7], and in patients with systemic lupus erythematosus (SLE) [8], all of which were absent in our patient.…”

Section: Discussionsupporting

confidence: 66%

Sequential occurrence of thrombotic thrombocytopenic purpura, essential thrombocythemia, and idiopathic thrombocytopenic purpura in a 42-year-old African-American woman: a case report and review of the literature

et al. 2012

View full text Add to dashboard Cite

Introduction Thrombotic thrombocytopenic purpura and idiopathic thrombocytopenic purpura are two well recognized syndromes that are characterized by low platelet counts. In contrast, essential thrombocythemia is a myeloproliferative disease characterized by abnormally high platelet numbers. The coexistence of thrombotic thrombocytopenic purpura and idiopathic thrombocytopenic purpura in a single patient has been reported in the literature on a few occasions. However, having essential thrombocythemia complicating the picture has never been reported before. Case presentation We present a case where thrombotic thrombocytopenic purpura, essential thrombocythemia, and idiopathic thrombocytopenic purpura were diagnosed in a 42-year-old African-American woman in the space of a few years; we are reporting this case with the aim of drawing attention to this undocumented occurrence, which remains under investigation. Conclusions As the three conditions have different natural histories and require different treatment modalities, it is important to recognize that these diseases may be seen sequentially. This case emphasizes the importance of reviewing peripheral blood smears for evaluation of thrombocytopenia and bone marrow aspirations for diagnosis of thrombocythemia in order to reach an accurate diagnosis and tailor therapy accordingly. Moreover, this case demonstrates the variability and complexity of platelet disorders. This occurrence of three different types of platelet disorders in one patient remains a pure observation on our part; regardless, this does raise the possibility of a common underlying, as yet undiscovered, pathophysiology that could explain the phenomenon.

show abstract

Section: Discussionsupporting

confidence: 66%

Sequential occurrence of thrombotic thrombocytopenic purpura, essential thrombocythemia, and idiopathic thrombocytopenic purpura in a 42-year-old African-American woman: a case report and review of the literature

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Clinical conditions that may raise the index of suspicion for the presence or development of such a mixed immune thrombocytopenia syndrome include underlying collagen vascular diseases, other autoimmune diseases, HIV infection, and pregnancy. In keeping with the conclusions of Stein et al [10], we wish to reemphasize that careful reevaluation of each episode of thrombocytopenia is necessary for the selection of appropriate therapy.…”

Section: Discussionmentioning

confidence: 91%

Four patients with both thrombotic thrombocytopenic purpura and autoimmune thrombocytopenic purpura: The concept of a mixed immune thrombocytopenia syndrome and indications for plasma exchange

Baron

Martin

Sucharetza

et al. 2001

J of Clinical Apheresis

View full text Add to dashboard Cite

Autoimmune thrombocytopenic purpura (ATP) and thrombotic thrombocytopenic purpura (TTP) are each well recognized clinical syndromes which may appear as single episodes or may have chronic relapsing courses. We present four patients negative for human immunodeficiency virus (HIV) infection who appear to have both diagnoses with either concomitant or intermingled episodes, and we review seven additional patients reported in the literature with similar features. All four of our patients are female, two have underlying connective tissue disorders, and their ATP processes came to our attention because of incomplete response of the platelet count to plasma exchange therapy (PEX) during a TTP phase (Cases 1 and 2) or development of thrombocytopenia in the absence of microangiopathy on the background of prior typical TTP episodes (Cases 3 and 4). Recognition of the ATP diagnosis in each case resulted in discontinuation of PEX (Cases 1 and 2) or not instituting PEX (Cases 3 and 4). In each instance, a satisfactory rise in platelet count followed treatment for ATP. Based upon this experience, we conclude that some individuals may have a mixed immune thrombocytopenia syndrome; careful analysis of the mechanism of thrombocytopenia, especially in recurrent episodes and in patients who respond incompletely to PEX for TTP, is important when deciding whether to initiate or continue PEX, or to consider therapies appropriate for other mechanisms of thrombocytopenia.

show abstract

“…For example, in their prospective study Diz-kucukkaya et al [16] have found the Anti Phospholipid Syndrome in 17% of newly diagnosed patients with ITP. Occasionally, thrombotic thrombocytopenic purpura develops after ITP [17,18].…”

Section: Discussionmentioning

confidence: 99%

Ischaemic Stroke in a Patient With Refractory Idiopathic Thrombocytopenic Purpura: An Unusual Clinical Dilemma

Hashmi

2012

J Med Cases

View full text Add to dashboard Cite

Idiopathic Thrombocytopenic Purpura (ITP) is commonly associated with bleeding complications, and thrombotic events are very rare. We report a patient with long standing ITP refractory to treatment who developed a large cerebral infarct. The patient's management was complicated by other co-morbidities, a bleeding tendency and recurrent cerebral ischaemia. A careful approach to treatment, based on the understanding of the patho-physiological mechanism of the patient's stroke, his co-morbidity and the estimated risk of haemorrhagic complications was required in this case.

show abstract

Idiopathic Thrombocytopenic Purpura During Remission of Thrombotic Thrombocytopenic Purpura

Cited by 15 publications

References 0 publications

Sequential occurrence of thrombotic thrombocytopenic purpura, essential thrombocythemia, and idiopathic thrombocytopenic purpura in a 42-year-old African-American woman: a case report and review of the literature

Sequential occurrence of thrombotic thrombocytopenic purpura, essential thrombocythemia, and idiopathic thrombocytopenic purpura in a 42-year-old African-American woman: a case report and review of the literature

Four patients with both thrombotic thrombocytopenic purpura and autoimmune thrombocytopenic purpura: The concept of a mixed immune thrombocytopenia syndrome and indications for plasma exchange

Ischaemic Stroke in a Patient With Refractory Idiopathic Thrombocytopenic Purpura: An Unusual Clinical Dilemma

Contact Info

Product

Resources

About