scholarly journals Moschcowitz Syndrome or Thrombotic Thrombocytopenic Purpura and Antiphospholipid Antibody Syndrome as a Rare Cause of Thrombocytopenia in Pregnancy Mimicking Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome in a Patient with Bad Obstetric History: A Diagnostic Dilemma

2020 ◽  
Vol 12 (4) ◽  
pp. 250-253
Author(s):  
Anupama Bhute ◽  
Sourya Acharya ◽  
Neema Acharya ◽  
Shazia Mohammad
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Liver Enzymes ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Diagnostic Dilemma ◽  
Thrombocytopenic Purpura ◽  
Obstetric History ◽  
Elevated Liver Enzymes ◽  
Moschcowitz Syndrome ◽  
In Pregnancy

scholarly journals Diagnostic dilemma: Severe thrombotic microangiopathy in pregnancy

2017 ◽  
Vol 18 (4) ◽  
pp. 348-351 ◽  
Author(s):  
Sarah Birkhoelzer ◽  
Alexandra Belcher ◽  
Helen Peet
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Haemolytic Anaemia ◽  
Thrombotic Microangiopathy ◽  
Interdisciplinary Approach ◽  
Severe Thrombocytopenia ◽  
Diagnostic Dilemma ◽  
Thrombocytopenic Purpura ◽  
Microangiopathic Haemolytic Anaemia ◽  
Elevated Liver Enzymes ◽  
In Pregnancy

A diagnostic dilemma occurred when thrombotic microangiopathy developed during pregnancy. The diagnostic criteria of thrombotic microangiopathy include thrombocytopenia (platelets <100) and microangiopathic haemolytic anaemia (including thrombotic thrombocytopenic purpura and haemolytic-uraemic syndrome). An urgent interdisciplinary approach is required to treat thrombotic microangiopathy in pregnancy to differentiate between thrombotic microangiopathy and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets).1 This case presented with the pentad of thrombotic thrombocytopenic purpura: severe thrombocytopenia (platelets 9 × 109/L), microangiopathic haemolytic anaemia (reticular count 245 × 109/L (20–110)), LDH >5000 U/L (<425)), neurological abnormalities (Glasgow Coma Scale 10/15), renal failure (creatinine 140 µmol/L (<97)), fever (37.7℃). A Disintegrin And Metalloproteinase with a Thrombospondin type 1 motif, member 13 (ADAMTS13) activity of less than 5% and anti-ADAMTS13 antibodies retrospectively confirmed the diagnosis of acquired idiopathic thrombotic thrombocytopenic purpura in pregnancy. The immediate management in the Emergency Department with an interdisciplinary team of Consultant Nephrologists, Intensivists, Haematologists and Obstetricians facilitated prompt diagnosis resulting in immediate plasma exchange (PEX) and coordination of semi-elective delivery of the foetus.

Thrombotic Thrombocytopenic Purpura Masquerading as Hemolysis, Elevated Liver Enzymes, Low Platelets (HELLP) Syndrome in Late Pregnancy

2006 ◽  
Vol 108 (Supplement) ◽  
pp. 817-820 ◽  
Author(s):  
Jonathan F. Rehberg ◽  
Christian M. Briery ◽  
William T. Hudson ◽  
James A. Bofill ◽  
James N. Martin
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Late Pregnancy ◽  
Thrombocytopenic Purpura ◽  
Elevated Liver Enzymes
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