Presence of ADAMTS13 activity in a patient with metastatic cancer and thrombotic microangiopathy.
Patients with metastatic cancers occasionally present with microangiopathic hemolysis and thrombocytopenia. A patient with metastatic adenocarcinoma of the colon and microangiopathic hemolysis was treated with plasma exchange for a presumptive diagnosis of thrombotic thrombocytopenic purpura (TTP). However, her condition continued to deteriorate and a determination of ADAMTS13 activity revealed that she did not have TTP. Despite similarity in clinical manifestation, microangiopathic hemolysis in patients with metastatic cancers may not be caused by ADAMTS13 deficiency and the role of plasma exchange in such patients should be reevaluated.
Forman
Robin B
RB
Beth Israel Medical Center, New York, NY, USA.
Benkel
Seth A
SA
Novik
Yelena
Y
Tsai
Han-Mou
HM
D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; D000230:Adenocarcinoma / Q000097:blood* / Q000150:complications* / Q000556:secondary; D000368:Aged; D003110:Colonic Neoplasms; D003951:Diagnostic Errors; D005260:Female; D006461:Hemolysis; D006801:Humans; D008666:Metalloendopeptidases / Q000097:blood* / Q000172:deficiency; D010951:Plasma Exchange / Q000009:adverse effects; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis / Q000628:therapy; D013927:Thrombosis / Q000097:blood* / Q000209:etiology*
D051722:ADAM Proteins; D008666:Metalloendopeptidases; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human