title: Thrombotic thrombocytopenic purpura and urinary tract infections: is there a connection?
abstract: Most cases of thrombotic thrombocytopenic purpura (TTP) are considered idiopathic without an identifiable etiologic agent. It has been previously reported that a number of patients with TTP had a urinary tract infection (UTI). Apheresis records were searched for patients with TTP from 1999 through 2007. Records were examined for evidence of UTI, and the patients were divided into 4 groups: 1, laboratory evidence of UTI on admission; 2, UTI just before admission; 3, UTI that developed during hospitalization; and 4, weak laboratory evidence of a UTI. The study included 90 TTP "visits." (A visit was defined as all admissions for TTP for a specific patient within a 1-month period.) Of the TTP visits, 21 (23%) were associated with UTIs. Group 1 included 7 patients; group 2, 10 patients; group 3, 3 patients; and group 4, 1 patient. This suggests that UTIs might serve as a TTP stimulus. Owing to the relatively strong association of UTIs with TTP, all patients with TTP should be screened for UTI and treated accordingly.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, USA.
authors.forename: Yara A
authors.initials: YA
authors.lastname: Park
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Schultz
authors.forename: Shauna N
authors.initials: SN
authors.lastname: Hay
authors.forename: Mark E
authors.initials: ME
authors.lastname: Brecher
mesh_terms: D051722:ADAM Proteins / Q000097:blood; D000071120:ADAMTS13 Protein; D001781:Blood Component Removal; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D018716:Molecular Mimicry; D009657:North Carolina / Q000453:epidemiology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000097:blood / Q000453:epidemiology* / Q000473:pathology
chemical_list: D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human