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Post-Partum Thrombotic Thrombocytopenic Purpura (TTP) in a Patient with known Idiopathic (Immune) Thrombocytopenic Purpura: a case report and review of the literature

Overview of attention for article published in Journal of Medical Case Reports, June 2018
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Title
Post-Partum Thrombotic Thrombocytopenic Purpura (TTP) in a Patient with known Idiopathic (Immune) Thrombocytopenic Purpura: a case report and review of the literature
Published in
Journal of Medical Case Reports, June 2018
DOI 10.1186/s13256-018-1692-1
Pubmed ID
Authors

Naser Al-Husban, Oqba Al-Kuran

Abstract

Incidences of immune thrombocytopenic purpura occur in 1 in every 1000-10,000 pregnancies accounting for 3% of all thrombocytopenic pregnancies. A pre-existing immune thrombocytopenic purpura is known to be a risk factor for developing thrombocytopenia during pregnancy. We present here the treatment regime and management of a patient with known immune thrombocytopenic purpura who developed postpartum thrombotic thrombocytopenia with atypical response to traditional therapy. Pregnant women are more vulnerable to immune thrombocytopenic purpura or thrombotic thrombocytopenia. Pregnancy or postpartum thrombotic thrombocytopenia accounts for 10-25% of all thrombotic thrombocytopenia. This case report deals with the treatment regime and management of a patient with known immune thrombocytopenic purpura who developed postpartum thrombotic thrombocytopenia. A 30-year-old Middle Eastern woman, with a prior diagnosis of chronic immune thrombocytopenic purpura had remained off-the-treatment for many years. After primary unexplained infertility for 8 years, for which she underwent six failed trials of in vitro fertilization, she delivered a healthy baby through caesarean section. Two days post-surgery, she had persistent thrombocytopenia, ecchymoses, bruises, and hemolysis. Her blood film revealed leukoerythroblastic anemia. Her blood tests also revealed a very low level of haptoglobin, and low level of ADAMTS13. A diagnosis of thrombotic thrombocytopenia was suspected. Plasma exchange therapy was started with partial response. We showed that rituximab in conjunction with mycophenolate mofetil following plasma exchange therapy was effective in controlling the low platelet count in our patient. Rituximab in conjunction with mycophenolate mofetil following plasma exchange therapy was effective in controlling the low platelet count in our patient. Only two doses of rituximab were sufficient to normalize our patient. We present here a case of safe and effective use of rituximab in pregnancy-induced thrombotic thrombocytopenia.

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The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 39 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 4 10%
Student > Bachelor 4 10%
Student > Postgraduate 3 8%
Professor > Associate Professor 3 8%
Other 2 5%
Other 6 15%
Unknown 17 44%
Readers by discipline Count As %
Medicine and Dentistry 18 46%
Biochemistry, Genetics and Molecular Biology 1 3%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Business, Management and Accounting 1 3%
Nursing and Health Professions 1 3%
Other 0 0%
Unknown 17 44%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 June 2018.
All research outputs
#10,395,574
of 13,034,624 outputs
Outputs from Journal of Medical Case Reports
#1,220
of 2,197 outputs
Outputs of similar age
#203,335
of 271,405 outputs
Outputs of similar age from Journal of Medical Case Reports
#1
of 1 outputs
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So far Altmetric has tracked 2,197 research outputs from this source. They receive a mean Attention Score of 3.2. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
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