Nurses best practices for the management of thrombotic thrombocytopenic purpura

Harmon, Pamela; Cojocari, Eduard; Mader, Catherine Lynn; Galloway, C A.; Buchholz, Megan; Lewis, Brenda; Sinclair, Susan

doi:10.1016/j.transci.2018.05.001

Cited by 2 publications

(6 citation statements)

References 14 publications

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“…The optimal treatment of TTP-associated ischemic strokes is apheresis with a plasma exchange that uses solvent/detergent-treated plasma containing the needed ADAMST13 enzyme. 30 This plasma exchange diminishes the likelihood of clotting with TTP. The VWFto-ADAMTS13 ratio has a strong correlation with risk of ischemic stroke in cases other than TTP.…”

Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

“…This finding has motivated research in the use of ADAMTS 13 as a site for pharmacological intervention for ischemic stroke of multiple origins. 30 Current studies are in the animal model stage.…”

Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

“…Activated VWF then leads platelets to adhere to vessel walls and activate leukocytes. 29,30 Congenital TTP is associated with an autosomal recessive gene that causes an abnormality in ADAMTS13 enzyme production and function. ADAMTS13 can also be an acquired deficiency associated with preeclampsia, infections, and diabetes.…”

Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

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Background: There are 2 classification of strokes: ischemic, if caused by an arterial occlusion from a clot or obstruction by atherosclerosis, and hemorrhagic, if caused by the rupture of a vessel and subsequent bleeding. Each type of stroke is influenced by platelet counts and platelet function. The intention of this article is to discuss the role of the platelet in the pathophysiology of acute stroke processes. This serves as a prelude to discussing these processes as disrupted with thrombocytopenia (low platelet counts). Platelets initiate clot formation and obstruct blood flow through the creation of a platelet plug. They also extend the penumbra in ischemic and hemorrhagic strokes. Thrombocytopenia can be a causal factor in an ischemic stroke, a risk factor for hemorrhagic stroke, and a risk factor for hemorrhagic stroke conversion. Methods: The aims of this study were to review 1 case study that illustrates the pivotal role of the platelet in strokes and to review the aspect that was impacted by autoimmune thrombocytopenia. Discussion: Thrombocytopenia is a hematologic disorder not often included in stroke care discussions. Thrombocytopenia sets up strokes to occur and, paradoxically, may also set the patient up for bleeding complications in the brain or groin. Conclusion: Acknowledging the impact of both platelet and thrombocytopenia on stroke causation, stroke interventions, and outcomes is a pivotal aspect of comprehensive stroke care. Platelet function processes are impactful in each point of the continuum of stroke care, prevention, intervention, and discharge.

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Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

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2021

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“…ADAMTS13 enzyme is responsible for deactivating von Willebrand factor (VWF) (a blood glycoprotein involved in hemostasis), which is released from the vascular endothelial cells. Activated VWF then leads platelets to adhere to vessel walls and activate leukocytes 29,30 . Congenital TTP is associated with an autosomal recessive gene that causes an abnormality in ADAMTS13 enzyme production and function.…”

Section: Ischemic Stroke: Thrombotic Thrombopenia Purpura Pathophysio...mentioning

confidence: 99%

“…The radiological characteristics of a TTP-associated ischemic stroke are multiple scattered lesions that extend beyond one single cerebral vessel territory. The optimal treatment of TTP-associated ischemic strokes is apheresis with a plasma exchange that uses solvent/detergent-treated plasma containing the needed ADAMST13 enzyme 30 . This plasma exchange diminishes the likelihood of clotting with TTP.…”

Section: Ischemic Stroke: Thrombotic Thrombopenia Purpura Pathophysio...mentioning

confidence: 99%