Successful plasma exchange in a 34‐year‐old woman with diabetic ketoacidosis and a thrombotic microangiopathy

Hermelin, Daniela; Blackall, Douglas P.

doi:10.1002/jca.21751

Cited by 2 publications

(2 citation statements)

References 12 publications

(14 reference statements)

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“…The management of TTP associated with DKA includes a multidisciplinary approach involving intensive care unit management, fluid and electrolyte management, glycemic control, and treatment of the underlying TTP [ 11 ]. Patients with TTP associated with DKA often require intensive care unit management with close monitoring of vital signs, urine output, and serum electrolytes [ 12 ]. Aggressive fluid and electrolyte replacement is essential to correct dehydration and electrolyte imbalances.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis Complicated by Thrombotic Thrombocytopenic Purpura: A Rare Association

Nwankwo¹,

Samuels²,

Abung³

et al. 2023

Cureus

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Thrombotic thrombocytopenic purpura (TTP) is a rare and potentially life-threatening blood disorder caused by a deficiency or dysfunction of ADAMTS13 and can occur secondary to various conditions, including autoimmune diseases, infections, medications, pregnancy, and malignancies. Diabetic ketoacidosis (DKA) inducing TTP is uncommon and not widely reported in the literature. Herein, we report a case of TTP induced by DKA in an adult patient. His clinical picture, serological, and biochemical results confirmed the diagnosis of TTP induced by DKA, and his clinical course did not improve despite normalization of glucose level, plasmapheresis, and aggressive management. Our case report emphasizes the importance of considering TTP as a potential complication of DKA.

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Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis Complicated by Thrombotic Thrombocytopenic Purpura: A Rare Association

Nwankwo¹,

Samuels²,

Abung³

et al. 2023

Cureus

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“…More serious and less common complications include arrhythmias and acute kidney injury [ 9 ]. Although coagulopathy in the setting of DKA is rarely reported, few cases have been reported [ 3 , 5 , 6 , 10 ]. Even though there is no concrete association between TTP and DKA, a relationship between the acute presentation of DKA with TTP has been postulated.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis: Possible Cause of Thrombotic Thrombocytopenic Purpura

Jackson¹,

Fischer²,

Abdelsayed³

et al. 2021

Cureus

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Acquired thrombotic thrombocytopenic purpura (TTP) is an uncommon microangiopathic disorder that can have variable presentations and can be precipitated by a multitude of stressors to the body, most commonly sepsis. TTP is caused by a deficiency of ADAMTS13 leading to intravascular clotting causing thrombocytopenia and microangiopathic hemolytic anemia. TTP can be associated with various other pathologic conditions. One such rare association has been reported with diabetic ketoacidosis (DKA). Here, we present an even less appreciated presentation in association with DKA. A 62-year-old African American male with previously diagnosed prediabetes presented with DKA and developed hemodynamically significant bleeding. He was confirmed to have TTP that responded to plasmapheresis. TTP is a life-threatening illness if not treated urgently with plasmapheresis with or without rituximab. As acquired TTP most commonly occurs during stress on the body, it is important to treat the underlying stressor. Early identification and initiation of appropriate interventions are crucial to reducing mortality associated with TTP. Furthermore, we need to appreciate less commonly associated conditions such as DKA among patients.

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Successful plasma exchange in a 34‐year‐old woman with diabetic ketoacidosis and a thrombotic microangiopathy

Cited by 2 publications

References 12 publications

Diabetic Ketoacidosis Complicated by Thrombotic Thrombocytopenic Purpura: A Rare Association

Diabetic Ketoacidosis Complicated by Thrombotic Thrombocytopenic Purpura: A Rare Association

Diabetic Ketoacidosis: Possible Cause of Thrombotic Thrombocytopenic Purpura

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