Pregnancy-associated thrombotic thrombocytopenic purpura

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245

Thrombotic microangiopathies: New developments and translation into medicine

Issue: 2009: 101/2 (Feb) pp. 217-412
Pages: 248-251

Pregnancy-associated thrombotic thrombocytopenic purpura

Jens Gerth 1; Ekkehard Schleussner 2; Karim Kentouche 3; Martin Busch 1; Mandy Seifert 1; Gunter Wolf1
1 Klinik für Innere Medizin III, Friedrich-Schiller-Universität, Jena, Germany; 2 Abteilung Geburtshilfe, Klinik für Frauenheilkunde und Geburtshilfe, Friedrich-Schiller-Universität, Jena, Germany; 3 Klinik für Kinder- und Jugendmedizin, Friedrich-Schiller-Universität, Jena, Germany


pregnancy, Thrombotic thrombocytopenic purpura, von Willebrand factor, Thrombocytopenia, ADAMTS 13, plasmapheresis


Thrombocytopenia during pregnancy is a common diagnostic and management problem. Several differential diagnosis must be considered including manifestations of thrombotic thrombocytopenic purpura (TTP). We report here on a case of a 21-yearold pregnant woman who presented initially severe thrombocytopenia (8 Gpt/l) in the 20th+1 week of gestation. The patient had an antibody against ADAMTS13, and enzyme activity was <5%. Immediate plasmapheresis treatment was initiated, followed by plasma infusions, and again plasmapheresis. A male neonate was delivered by caesarean section in the 32nd week of gestation. The child had an uncomplicated postnatal development. After delivery, the mother’s platelet count and ADAMTS13 activity increased to normal values. This case shows interesting aspects of TTP in pregnancy and a close cooperation between obstetricians, nephrologists and pediatricians is necessary for a successful outcome of the pregnancy.

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