The challenges of diagnosing thrombotic thrombocytopenic purpura in the critically ill. A case report.
Thrombotic thrombocytopenic purpura (TTP) is associated with high mortality rates. TTP may have various and different presentations depending on the organs involved. It is now recognized to be the consequence of reduction of blood levels of the disintegrin and metalloprotease with thrombospondin motifs (ADAMTS)-13. Prompt diagnosis of TTP is paramount, because plasma exchange is the only treatment capable of improving patient's survival with a dual mechanism: removal of anti-ADAMTS-13 auto-antibodies and infusion of the active protease available in the fresh frozen plasma. We report herein on the challenges in diagnosing TTP-like complications of post-surgical facial surgery in a young male patient.
Bindi
Maria Lucia
ML
Anestesia e Rianimazione SSN, Italy. l.bindi@ao-pisa.toscana.it
Mazzoni
Alessandro
A
Bisà
Massimo
M
Grazzini
Tiziana
T
Esposito
Massimo
M
Meacci
Luca
L
Mozzo
Roberto
R
Scatena
Fabrizio
F
Biancofiore
Gianni
G
D051722:ADAM Proteins / Q000097:blood; D000071120:ADAMTS13 Protein; D000328:Adult; D001323:Autoantibodies / Q000737:chemistry; D015925:Cryopreservation; D005145:Face / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010949:Plasma / Q000378:metabolism; D010951:Plasma Exchange / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis*
D001323:Autoantibodies; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human