Thrombotic thrombocytopenic purpura and acquired immunodeficiency syndrome diagnosed in pregnancy: Case report.
Thrombotic thrombocytopenic purpura (TTP) is a medical emergency that demands prompt diagnosis to allow lifesaving treatment: plasmapheresis. TTP during pregnancy is rare, with estimated prevalence of 1/200 000, and even rarer in association with acquired immunodeficiency syndrome, with only two cases reported. Differential diagnosis includes HELLP syndrome (hemolysis elevated liver enzymes and low platelets), sepsis, intravascular-disseminated coagulation, and acquired autoimmune diseases, each one with its unique treatment and prognosis. A case of a pregnant woman at 26th week with sudden onset of left hand paresthesia and purpura is reported. PLASMIC score showed high risk for ADAMTS-13 deficiency and diagnosis of TTP was made. Human immunodeficiency virus screening test was positive on admission. Plasmapheresis and antiretroviral therapy were initiated and the delivery of a healthy newborn at full-term gestation was achieved, unlike other cases in literature. No obstetric complications were observed and the follow-up shows no signs of disease recurrence.
['Marins|Lina R|LR|', 'da Rocha Oppermann|Maria L|ML|']
D000163:Acquired Immunodeficiency Syndrome D004211:Disseminated Intravascular Coagulation D005260:Female D017359:HELLP Syndrome D006461:Hemolysis D006801:Humans D007231:Infant, Newborn D011247:Pregnancy D011697:Purpura, Thrombotic Thrombocytopenic
thrombotic thrombocytopenic purpura acquired immunodeficiency syndrome pregnancy HIV placenta