title: The challenges of diagnosing thrombotic thrombocytopenic purpura in the critically ill. A case report.
abstract: 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.
authors.affiliation: Anestesia e Rianimazione SSN, Italy. l.bindi@ao-pisa.toscana.it
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Bindi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mazzoni
authors.forename: Massimo
authors.initials: M
authors.lastname: Bisà
authors.forename: Tiziana
authors.initials: T
authors.lastname: Grazzini
authors.forename: Massimo
authors.initials: M
authors.lastname: Esposito
authors.forename: Luca
authors.initials: L
authors.lastname: Meacci
authors.forename: Roberto
authors.initials: R
authors.lastname: Mozzo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Scatena
authors.forename: Gianni
authors.initials: G
authors.lastname: Biancofiore
mesh_terms: 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*
chemical_list: D001323:Autoantibodies; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human