title: Influenza A infection triggers thrombotic thrombocytopenic purpura by producing the anti-ADAMTS13 IgG inhibitor.
abstract: A 68-year-old Japanese woman infected with influenza A developed thrombotic thrombocytopenic purpura (TTP) 2 days after having a fever. Routine laboratory tests on admission suggested a diagnosis of disseminated intravascular coagulation. However, ADAMTS13 assays showed an extremely low level of plasma ADAMTS13 activity with a high titer of anti-ADAMTS13 inhibitor (IgG). Despite high-dose methylprednisolone therapy with daily plasma exchange for 3 consecutive days, the patient died of pulmonary congestion complicated by cardiac failure. Our experience here provides the first evidence that influenza A infection is sufficient to trigger TTP by producing the anti-ADAMTS13 IgG inhibitor.
authors.affiliation: Department of Internal Medicine, Numazu City Hospital, Numazu.
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Kosugi
authors.forename: Yuya
authors.initials: Y
authors.lastname: Tsurutani
authors.forename: Ayami
authors.initials: A
authors.lastname: Isonishi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hori
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fujimura
mesh_terms: D051722:ADAM Proteins / Q000037:antagonists & inhibitors* / Q000097:blood / Q000276:immunology; D000071120:ADAMTS13 Protein; D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000097:blood / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D009980:Influenza A virus; D007251:Influenza, Human / Q000097:blood / Q000150:complications* / Q000276:immunology; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000209:etiology* / Q000276:immunology
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G; C048844:anti-IgG; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human