Table 1 Summary of cases of immune thrombocytopenic purpura complicated with thrombotic thrombocytopenic purpura
Reference | Underlying condition | Age and sex | Race | PLT (× 109) | LDH (U/L) | ADAMTS13 activity | ADAMTS13 inhibitor | Sequence | Clinical presentation | Therapy | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
Zacharski 1976 [12] | None | 26/M | NS | 50 | NS | NS | NS | ITP Prior to TTP | Fever, lethargy, dizziness, weakness of extremities, aphasia | St, SP, aspirin, dipyridamole | R |
Stein 1984 [13] | None | 22/M | White | 25 | NS | NS | NS | TTP prior to ITP | Fever, ecchymosis, seizure, unresponsive, AKI | St, PEX, SP | R |
Stein 1984 [13] | None | 34/F | NS | 12 | NS | NS | NS | TTP prior to ITP | Fever, ecchymosis, confusion, headache | St, PEX, SP, V | R |
Stein 1984 [13] | Postpartum | 17/F | Black | 12 | NS | NS | NS | TTP prior to ITP | Fever, AKI, nerve palsy | St, PEX, SP | R |
Meiscnberg 1988 [14] | HIV | 25/M | NS | 10 | 945 | NS | NS | TTP prior to ITP | Nausea, vomiting, jaundice | PEX | R |
Krupsky 1991 [15] | None | 14/F | Indian | 41 | NS | NS | NS | ITP prior to TTP | Fever, headache, vaginal bleeding, vomiting, aphasia, paresis, seizure, cardiac arrest | St, SP, V, PEX | Died |
Routy 1991 [16] | HIV | 35/M | NS | 40 | 470 | NS | NS | ITP prior to TTP | Fever, confusion, RF | St, PEX, SP | Died |
Routy 1991 [16] | HIV | 31/M | NS | 15 | 27.5 | NS | NS | ITP prior to TTP | Fever, nausea, icterus, convulsion, AKI | PEX, V, St | R |
Shivaram 1992 [17] | HIV | 34/M | NS | 10 | NS | NS | NS | ITP prior to TTP | Fever, mental status changes | PEX | R |
Olenic 1994 [18] | Postpartum | 15/F | NS | 7 | 1932 | NS | NS | ITP prior to TTP | Ecchymosis | St, intravenous IG, PEX | R |
Yospur 1996 [7] | HIV | 42/M | NS | NS | NS | NS | NS | ITP prior to TTP | Fever, mental status changes | PEX, St, V | R But died of PJP |
Yospur 1996 [7] | HIV | 38/F | Hispanic | 7 | 778 | NS | NS | Concurrence | Headache, ecchymosis, petechiae, aphasia, paresthesias, cramping, seizure | St, PEX | R |
Prasad 1996 [19] | HIV | 9/M | NS | 6 | 1569 | NS | NS | ITP prior to TTP | Fever, vomiting, petechiae, paresthesia, aphasia, hemiparesis | St, V, intravenous IG, PEX | R |
Baron 2001 [20] | SLE/MCTD | 55/F | African American | 14 | 1107 | NS | NS | TTP Prior to ITP | Fever, seizures, unresponsive, AMI, AKI, ecchymosis | St, PEX, intravenous IG | R |
Baron 2001 [20] | RA | 62/F | White | 14 | 2656 | NS | NS | ITP prior to TTP | Petechiae, cerebral ischemia | St, V, PEX and intravenous IG | R |
Baron 2001 [20] | Positive Coombs test | 28/F | African American | 13 | 1204 | NS | NS | TTP prior to ITP | Fever, ecchymosis, headache, CPA | PEX, St | Died |
Baron 2001 [20] | None | 45/F | Caucasian | 14 | normal | NS | NS | TTP prior to ITP | Fever, petechiae, mental status changes, hematuria | PEX, St, intravenous IG | R |
Bayrakta 2010 [20] | Metastatic neuroendocrine tumor on bevacizumab | 63/F | Hispanic | 16 | 4233 | normal | NS | Concurrence | Pallor, jaundice | PEX, intravenous IG, V, St, rituximab, CTX | R |
Changela 2011 [22] | Prostate cancer | 60/M | NS | 8 | 1348 | 12% | ( +) | ITP prior to TTP | Fever gingival bleed, chest pain, shortness of breath, hematuria, intracranial bleed, AKI | St, PEX, intravenous IG, rituximab | R |
Farhat 2012 [23] | None | 42/F | African American | 34 | NS | NS | NS | TTP prior to ITP | Slurring of speech, left upper extremity weakness | St, intravenous IG, V, PEX | R |
Husban 2018 [8] | Postpartum | 30/F | Middle Eastern | 56 | 28.4 | 11% | NS | ITP prior to TTP | Fever ecchymosis, headache, fatigue, dizziness liver function impairment | St, PEX, MMF, rituximab | R |
Devon 2021 [9] | Primary Sjögren’s syndrome | 72/M | Caucasian | 9 | 2,399 | 9% | ( +) | ITP prior to TTP | Ecchymosis, epistaxis, hematuria, AKI | St, MMF, romiplostim, intravenous IG, PEX, rituximab | R |
Hangping Ge [24] 2022 | None | 33/F | Asian | 5 | 543 | 0% | ( +) | ITP prior to TTP | Ecchymosis, weakness, heavy menstrual bleeding | St, intravenous IG, PEX, rituximab, MMF | R |
Present study | None | 32/F | Asian | 28 | 330 | 1.665% | ( +) | Concurrence | Petechiae, headache | St, PEX | R |