Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

02 August 2021: Articles

Acquired Thrombotic Thrombocytopenic Purpura Without Anti-ADAMTS13 Antibody Caused by Influenza A (H1N1) Virus Successfully Treated by Plasma Exchange: A Case Report

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Keisuke Kubo A* , Tomohiro Abe A , Noriaki Kawano B , Hidenobu Ochiai A

DOI: 10.12659/AJCR.932251

Am J Case Rep 2021; 22:e932251

Figure 2. Clinical course during hospitalization. We diagnosed respiratory failure due to pneumonia, and disseminated intravascular coagulation (DIC) on admission. We began administering ceftriaxone, levofloxacin, steroid pulse therapy, peramivir, and recombinant human thrombomodulin. On day 3 of hospitalization, the platelet count decreased dramatically, and the lactate dehydrogenase (LDH) concentration increased markedly. Thrombocytopenia persisted despite platelet transfusion. On day 8, we diagnosed TMA because of the presence of fragmented erythrocytes in the blood smear, thrombocytopenia, and elevated LDH concentration, and we initiated plasma exchange therapy. We administered rituximab on day 8 because the patient had neuropsychiatric symptoms. After 4 plasma exchanges and rituximab once a week for 2 weeks, platelet numbers and LDH concentration normalized on day 16. The result of chromogenic ADAMTS13-act-ELISA was <0.5%. The patient was discharged home on day 41, and we subsequently submitted a nasopharyngeal specimen collected on admission to the National Institute of Public Health and the Environment, which identified influenza A virus infection. Therefore, we finally diagnosed secondary TTP associated with influenza A virus.0

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923