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

Lotta, Luca A.; Degasperi, Elisabetta; Aghemo, Alessio; Ferrari, Barbara; Peyvandi, Flora; Colombo, Massimo

doi:10.1111/j.1365-3148.2012.01197.x

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…The onset of disease is variable, too, with the first manifestations occurring in the neonatal period up to adulthood. The age of onset and recurrence rate are determined by genetic background and by the exposure to environmental risk factors acting as triggers, such as pregnancy and certain drugs . The rarity of cTTP and its variable phenotype may often delay the correct diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Risk of diagnostic delay in congenital thrombotic thrombocytopenic purpura

Ferrari

Cairo

Pagliari

et al. 2019

Journal of Thrombosis and Haemostasis

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Congenital thrombotic thrombocytopenic purpura (cTTP) is a very rare thrombotic microangiopathy. Its rarity and great phenotype heterogeneity may account for misdiagnosis. We report the history of a middle‐aged woman with cTTP, misdiagnosed until adulthood. Accurate clinical history is crucial for early diagnosis to prevent long‐term sequelae. Summary Thrombotic thrombocytopenic purpura (TTP) is an acute life‐threatening disorder characterized by multiple organ ischemia due to disseminated thrombus formation in the microvasculature. The congenital form of the disease (Upshaw‐Schulman syndrome) is related to ADAMTS13 mutations. Adulthood‐onset of TTP does not exclude the congenital form of the disease and a diagnostic delay may account for a great morbidity burden in these patients. We describe the case of a middle‐aged woman who presented to our attention with a clinical diagnosis of a chronic relapsing form of TTP. The medical history of the patient raised the suspicion of a congenital form of TTP. Phenotype and genotype tests were performed, and clinical diagnosis was confirmed. Upshaw‐Schulman syndrome is a rare congenital disease with a great phenotype heterogeneity that can be diagnosed also in adulthood. Accurate clinical history is crucial. Early diagnosis can prevent recurrences and long‐term organ damage with long‐term sequelae.

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Section: Introductionmentioning

confidence: 99%

Risk of diagnostic delay in congenital thrombotic thrombocytopenic purpura

Ferrari

Cairo

Pagliari

et al. 2019

Journal of Thrombosis and Haemostasis

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Association of thrombotic microangiopathy with interferon therapy for hepatitis B: a case report

Wei,

Mei,

Wang

2024

J Med Case Reports

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Background Thrombotic microangiopathy is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ injury. The pathological features include vascular damage that is manifested by arteriolar and capillary thrombosis with characteristic abnormalities in the endothelium and vessel wall. Thrombocytopenia is one of the common adverse effects of interferon therapy. However, a more serious but rare side effect is thrombotic microangiopathy. Case presentation We report the case of a 36-year-old Asian male patient with clinical manifestations of hypertension, blurred vision, acute renal failure, thrombocytopenia, and thrombotic microangiopathy. Renal biopsy showed interstitial edema with fibrosis, arteriolar thickening with vitreous changes, and epithelial podocytes segmental fusion. Immunofluorescence microscopy showed C3(+), Ig A(+) deposition in the mesangial region, which was pathologically consistent with thrombotic microangiopathy renal injury and Ig A deposition. The patient had a history of hepatitis B virus infection for more than 5 years. Lamivudine was used in the past, but the injection of long-acting interferon combined with tenofovir alafenamide fumarate was used since 2018. The comprehensive clinical investigation and laboratory examination diagnosed the condition as thrombotic microangiopathy kidney injury caused by interferon. After stopping interferon in his treatment, the patient’s renal function partially recovered after three consecutive therapeutic plasma exchange treatments and follow-up treatment without immunosuppressant. The renal function of the patient remained stable. Conclusions This report indicates that interferon can induce thrombotic microangiopathy with acute renal injury, which can progress to chronic renal insufficiency.

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

Cited by 2 publications

References 14 publications

Risk of diagnostic delay in congenital thrombotic thrombocytopenic purpura

Risk of diagnostic delay in congenital thrombotic thrombocytopenic purpura

Association of thrombotic microangiopathy with interferon therapy for hepatitis B: a case report

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