title: Life after acquired thrombotic thrombocytopenic purpura: morbidity, mortality, and risks during pregnancy.
abstract: Patients who have recovered from their acute episode of acquired ADAMTS13-deficient thrombotic thrombocytopenic purpura (TTP) were once thought to have complete recovery except for risk of relapse. Data from previous publications from the Oklahoma TTP-hemolytic uremic syndrome (HUS) Registry are summarized. Patients have decreased cognitive function and increased prevalence of hypertension, systemic lupus erythematosus, major depression, and albuminuria as compared to the expected values from the US population. The proportion of patients that died during the follow-up period was greater than expected based on the US population reference population. Among women who had a pregnancy following recovery from TTP, relapse during pregnancy or postpartum is uncommon, but the occurrence of preeclampsia may be increased. Thirteen of 16 pregnancies in these women resulted in healthy children. Increased morbidity and mortality in TTP patients following recovery suggest that TTP may be more of a chronic disorder than a disorder with acute episodes and complete recovery.
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Vesely
mesh_terms: D051722:ADAM Proteins / Q000097:blood / Q000172:deficiency; D000071120:ADAMTS13 Protein; D015415:Biomarkers / Q000097:blood; D003072:Cognition Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D009825:Oklahoma / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011256:Pregnancy Outcome; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human
keywords: ADAMTS13 protein, human; mortality; outcomes assessment; pregnancy; thrombotic thrombocytopenic purpura