title: Thrombotic thrombocytopenic purpura and pregnancy: a case report and a review of the literature.
abstract: Thrombotic thrombocytopenic purpura (TTP) is a severe disorder affecting the microcirculation of multiple organ systems. Plasma therapy has significantly reduced the mortality rate. Infections, pregnancy, cancers, drugs, and surgery were frequently associated with the initial episodes and relapses. Women who are either pregnant or in the postpartum period make up 10-25% of TTP patients, suggesting the interrelationship between TTP and pregnancy. The introduction of aggressive treatment with plasma transfusion or plasmapheresis improved maternal and fetal survival rates. We describe a case of a first successful pregnancy concomitant to a late relapse of TTP, in which the identification of important risk factors for both TTP and pregnancy allowed us easier hematological and obstetrical management. Proposed guidelines for pregnancy-related TTP management and a brief review of current treatment options for this rare condition are also included.
authors.affiliation: Ematologia, Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Proia
authors.forename: R
authors.initials: R
authors.lastname: Paesano
authors.forename: F
authors.initials: F
authors.lastname: Torcia
authors.forename: L
authors.initials: L
authors.lastname: Annino
authors.forename: S
authors.initials: S
authors.lastname: Capria
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
authors.forename: G
authors.initials: G
authors.lastname: Ferrazza
authors.forename: E
authors.initials: E
authors.lastname: Pacifici
authors.forename: A
authors.initials: A
authors.lastname: Pantalissi
authors.forename: G
authors.initials: G
authors.lastname: Meloni
mesh_terms: D000328:Adult; D001241:Aspirin / Q000008:administration & dosage; D019468:Disease Management; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D012008:Recurrence; D012307:Risk Factors
chemical_list: D006493:Heparin; D001241:Aspirin