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Romão de Souza V, Beatriz Cavalcante de Oliveira A, Maria Vanderlei A, Queiroz da Mota Silveira Aroucha A, Pontes Duarte B, Nunes Machado A, Netto Chaer L, Wanderley de Barros Correia C, da Conceição de Barros Correia M, Freire Hazin Costa M. Inherited thrombotic thrombocytopenic purpura mimicking immune thrombocytopenic purpura during pregnancy: a case report. J Med Case Rep 2018; 12:15. [PMID: 29357939 PMCID: PMC5778757 DOI: 10.1186/s13256-017-1545-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/11/2017] [Indexed: 12/21/2022] Open
Abstract
Background Thrombotic thrombocytopenic purpura is a very rare hereditary blood deficiency disorder of ADAMTS13 (von Willebrand factor-cleaving protease) and a life-threatening thrombotic microangiopathy characterized by thrombocytopenia and microangiopathic hemolytic anemia. The deficiency in ADAMTS13 metalloprotease, which cleaves the von Willebrand factor, may be congenital or acquired. The congenital form is caused by inherited mutations in the ADAMTS13 gene. The diagnosis is challenging due to the nonspecific signs and symptoms, as well as the rarity of the disease. Case presentation We present an unusual case of a 20-year-old feoderm woman from northeast region of Brazil who manifested thrombocytopenia during her pregnancy which was believed to be immune thrombocytopenic purpura. Conclusions Considering the importance of a differential diagnosis of thrombotic microangiopathic disorders, congenital thrombotic thrombocytopenic purpura may mimic the signs and symptoms of pre-eclampsia/eclampsia, hemolysis with elevated liver enzymes and low platelet count syndrome, and atypical hemolytic-uremic syndrome. It should be considered in suspect cases in patients with an ADAMTS13 activity at 5% without ADAMTS13 antibodies.
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Affiliation(s)
- Valter Romão de Souza
- Department of Internal Medicine, Federal University of Pernambuco, Haematology, Av. Prof. Moraes Rego 1235, 50670-90, Recife, Brazil. .,Liga Acadêmica de Hematologia da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego 1235, 50670-901, Recife, Brazil. .,Hospital das Clínicas, Federal University of Pernambuco, Av. Prof. Moraes Rego 1235, 50670-90, Recife, Pernambuco, Brazil.
| | - Ana Beatriz Cavalcante de Oliveira
- Department of Internal Medicine, Federal University of Pernambuco, Haematology, Av. Prof. Moraes Rego 1235, 50670-90, Recife, Brazil.,Liga Acadêmica de Hematologia da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego 1235, 50670-901, Recife, Brazil
| | - Ana Maria Vanderlei
- Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), R. Joaquim Nabuco 171, 52011-000, Recife, Brazil
| | | | - Bruna Pontes Duarte
- Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), R. Joaquim Nabuco 171, 52011-000, Recife, Brazil
| | - Aureli Nunes Machado
- Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), R. Joaquim Nabuco 171, 52011-000, Recife, Brazil
| | - Lívia Netto Chaer
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), R. dos Coelhos 300, 50070-550, Recife, Brazil
| | - Cláudia Wanderley de Barros Correia
- Liga Acadêmica de Hematologia da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego 1235, 50670-901, Recife, Brazil.,Hospital das Clínicas, Federal University of Pernambuco, Av. Prof. Moraes Rego 1235, 50670-90, Recife, Pernambuco, Brazil
| | - Maria da Conceição de Barros Correia
- Department of Internal Medicine, Federal University of Pernambuco, Haematology, Av. Prof. Moraes Rego 1235, 50670-90, Recife, Brazil.,Liga Acadêmica de Hematologia da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego 1235, 50670-901, Recife, Brazil.,Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), R. Joaquim Nabuco 171, 52011-000, Recife, Brazil
| | - Manuela Freire Hazin Costa
- Department of Internal Medicine, Federal University of Pernambuco, Haematology, Av. Prof. Moraes Rego 1235, 50670-90, Recife, Brazil.,Liga Acadêmica de Hematologia da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego 1235, 50670-901, Recife, Brazil.,Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), R. Joaquim Nabuco 171, 52011-000, Recife, Brazil.,Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), R. dos Coelhos 300, 50070-550, Recife, Brazil
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