We report the case of a Jehovah's Witness adolescent patient with immune-mediated thrombotic thrombocytopenic purpura after SARS-Cov2 infection successfully treated without therapeutic plasma exchange (TPE) using caplacizumab, corticosteroids, rituximab, and extracorporeal immunoadsorption (EIA). Further patients for whom TPE is not an option might benefit from this approach.
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http://dx.doi.org/10.1002/ccr3.5902 | DOI Listing |
Eur J Intern Med
January 2025
Laboratory of Pathology, Hebei Medical University, No. 361, Zhongshan Eastern Road, Shijiazhuang 050000, China. Electronic address:
Cureus
November 2024
Department of Medicine, Mercyhealth Graduate Medical Education (GME) Consortium, Rockford, USA.
Thrombotic microangiopathies (TMA) are a group of conditions that present with varying degrees of microthrombi, thrombocytopenia, microangiopathic hemolytic anemia, renal dysfunction, and neurological impairment. Etiologies can be primary, such as thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and atypical hemolytic uremic syndrome (aHUS), or secondary, such as due to systemic infections, malignancies, immune-mediated conditions, and hypertensive emergencies. In hypertensive emergencies, this presentation can occur from mechanical stress placed on red blood cells as they pass through narrowed arteries due to edema and microangiopathic changes within the vessels themselves.
View Article and Find Full Text PDFMod Pathol
December 2024
Expert Center for Immune-mediated Kidney Diseases and Vasculitis, Maastricht University Medical Center, Maastricht, The Netherlands; Dept. Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands. Electronic address:
The syndromes of thrombotic microangiopathy (TMA) are associated with acute kidney injury and end-stage kidney disease (ESKD). TMAs typically present with thrombocytopenia and microangiopathic hemolytic anemia (i.e.
View Article and Find Full Text PDFRes Pract Thromb Haemost
November 2024
Sanofi, Ghent, Belgium.
Background: International Society on Thrombosis and Haemostasis guidelines for immune-mediated thrombotic thrombocytopenic purpura (iTTP) treatment recommend concurrent therapeutic plasma exchange (TPE), immunosuppressive therapy (IST), and caplacizumab. TPE can complicate antidrug antibody (ADA) measurements by transferring pre-existing antibodies (pre-Abs) into patients via donor plasma and/or diluting treatment-emergent (TE) ADAs.
Objectives: To assess the presence of ADAs in patients with iTTP who received caplacizumab.
Am J Hematol
February 2025
Centre de Référence Des Microangiopathies Thrombotiques, Service d'hématologie, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France.
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