References in periodicals archive ?
The incidence in the region of the Oklahoma TTP-HUS Registry for all patients who are clinically diagnosed with TTP is 11.
4,9,12) Finally, some patients in the Oklahoma TTP-HUS Registry have had an established SLE diagnosis; we describe these patients as having both SLE and TTP, (4,9) but we recognize that accurate diagnosis of these patients is difficult.
We previously reported 17 patients with quinine-associated TTP-HUS (18).
The patients described here are from the Oklahoma TTP-HUS registry (20) and were included in a previous report describing quinine-associated TTP-HUS (18).
The increased LDH level was considered to be due to both hemolysis and muscle ischemia, as both typically occur in TTP-HUS (22).
However, when the previous history of TTP-HUS was recognized, plasma exchange was begun.
In 1995, quinine-associated TTP-HUS had been recently reported (16, 23), and it was during this episode that the association of her episodes with quinine was recognized.
This presumably occurs because of severe systemic muscle ischemia caused by systemic microvascular thrombosis (22), the principal pathogenic feature of TTP-HUS.
Because of the acute hematologic and renal abnormalities, TTP-HUS was suspected, and plasma exchange and hemodialysis were begun the day after admission.
TTP-HUS is a relatively uncommon, life-threatening cause of thrombocytopenia.
It is important to consider TTP-HUS as a differential.
Pathophysiologic classification of thrombocytopenia Decreased Production Increased Destruction * Hematologic malignancies Immune * Aplastic anemia * ITP * Myelodysplasia * HIT * Drugs: chemotherapy, alcohol * Drug-induced antibodies * Radiation * HIV * HIV * Post transfusion purpura * Vitamin D deficiencies * Connective tissue diseases * Hereditary thrombocytopenias Nonimmune * Metastatic cancer to bone marrow * DIC * Sepsis * Cardiac valves * TTP-HUS * Kasabach Merrit syndrome Splenic Sequestration * Hypersplenism HIV, human immunodeficiency virus; ITP, idiopathic thrombocytopenic purpura; HIT, heparin-induced thrombocytopenia; DIC, disseminated intravascular coagulation; TTP-HUS, thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.
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