Pregnancy outcomes following recovery from acquired thrombotic thrombocytopenic purpura.

Jiang, Yang; McIntosh, Jennifer J; Reese, Jessica A; Deford, Cassandra C; Kremer Hovinga, Johanna Anna; Lämmle, Bernhard; Terrell, Deirdra R; Vesely, Sara K; Knudtson, Eric J; George, James N (2014). Pregnancy outcomes following recovery from acquired thrombotic thrombocytopenic purpura. Blood, 123(11), pp. 1674-80. American Society of Hematology 10.1182/blood-2013-11-538900

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Pregnancy may precipitate acute episodes of thrombotic thrombocytopenic purpura (TTP), but pregnancy outcomes in women who have recovered from acquired TTP are not well documented. We analyzed pregnancy outcomes following recovery from TTP associated with acquired, severe ADAMTS13 deficiency (ADAMTS13 activity <10%) in women enrolled in the Oklahoma TTP-HUS Registry from 1995 to 2012. We also systematically searched for published reports on outcomes of pregnancies following recovery from TTP associated with acquired, severe ADAMTS13 deficiency. Ten women in the Oklahoma Registry had 16 subsequent pregnancies from 1999 to 2013. Two women had recurrent TTP, which occurred 9 and 29 days postpartum. Five of 16 pregnancies (31%, 95% confidence interval, 11%-59%) in 3 women were complicated by preeclampsia, a frequency greater than US population estimates (2.1%-3.2%). Thirteen (81%) pregnancies resulted in normal children. The literature search identified 382 articles. Only 6 articles reported pregnancies in women who had recovered from TTP associated with acquired, severe ADAMTS13 deficiency, describing 10 pregnancies in 8 women. TTP recurred in 6 pregnancies. Conclusions: With prospective complete follow-up, recurrent TTP complicating subsequent pregnancies in Oklahoma patients is uncommon, but the occurrence of preeclampsia may be increased. Most pregnancies following recovery from TTP in Oklahoma patients result in normal children.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Kremer Hovinga, Johanna Anna and Lämmle, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0006-4971

Publisher:

American Society of Hematology

Language:

English

Submitter:

Verena Zwahlen

Date Deposited:

11 Jun 2014 10:24

Last Modified:

02 Dec 2015 13:14

Publisher DOI:

10.1182/blood-2013-11-538900

PubMed ID:

24398329

BORIS DOI:

10.7892/boris.48673

URI:

https://boris.unibe.ch/id/eprint/48673

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