Current insights into thrombotic microangiopathies: Thrombotic thrombocytopenic purpura and pregnancy.

von Auer, Charis; von Krogh, Anne-Sophie; Kremer Hovinga, Johanna Anna; Lämmle, Bernhard (2015). Current insights into thrombotic microangiopathies: Thrombotic thrombocytopenic purpura and pregnancy. Thrombosis research, 135(Suppl1), S30-S33. Elsevier 10.1016/S0049-3848(15)50437-4

	Text JKH_R017 von Auer C et al Thromb Res 2015 135 (Suppl 1) S30-S33.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (399kB)
Preview	Text JKH_BL_Current_Insights_into_Thrombotic_Microangiopathies.pdf - Submitted Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (157kB) | Preview

The complex relation between thrombotic thrombocytopenic purpura (TTP) and pregnancy is concisely reviewed. Pregnancy is a very strong trigger for acute disease manifestation in patients with hereditary TTP caused by double heterozygous or homozygous mutations of ADAMTS13 (ADisintegrin And Metalloprotease with ThromboSpondin type 1 domains, no. 13). In several affected women disease onset during their first pregnancy leads to the diagnosis of hereditary TTP. Without plasma treatment mother and especially fetus are at high risk of dying. The relapse risk during a next pregnancy is almost 100% but regular plasma transfusion starting in early pregnancy will prevent acute TTP flare-up and may result in successful pregnancy outcome. Pregnancy may also constitute a mild risk factor for the onset of acute acquired TTP caused by autoantibody-mediated severe ADAMTS13 deficiency. Women having survived acute acquired TTP may not be at very high risk of TTP relapse during an ensuing next pregnancy but seem to have an elevated risk of preeclampsia. Monitoring of ADAMTS13 activity and inhibitor titre during pregnancy may help to guide management and to avoid disease recurrence. Finally, TTP needs to be distinguished from the much more frequent hypertensive pregnancy complications, preeclampsia and especially HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelet count) syndrome.

Interest & Impact

Downloads

610 since deposited on 07 Mar 2016
10 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item