Thrombotic thrombocytopenic purpura in a newborn.
This report describes a newborn who presented with hyperbilirubinemia and thrombocytopenia. The patient recovered after treatment with antibiotics, phototherapy, and a platelet transfusion. Analysis of the plasma von Willebrand factor-cleaving metalloprotease, ADAMTS13, revealed low protease activity in the patient and her two siblings, and a mild deficiency in both parents. These results confirmed the clinical suspicion of hereditary thrombotic thrombocytopenic purpura (TTP). Although most cases of thrombocytopenia and hyperbilirubinemia in the newborn period are caused by other causes, genetic deficiency of ADAMTS13 may not be as uncommon as previously believed. Early diagnosis may have important implications for the patients.
Jubinsky
Paul T
PT
Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA.
Moraille
Richard
R
Tsai
Han-Mou
HM
D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000209:etiology; D008666:Metalloendopeptidases / Q000172:deficiency*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000151:congenital / Q000175:diagnosis*; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor; D051722:ADAM Proteins; D008666:Metalloendopeptidases; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human