Thrombotic Thrombocytopenic Purpura in Interferon Beta-1a-Treated Patient Diagnosed with Relapsing-Remitting Multiple Sclerosis: A Case Report.

Autor: Plesa CF; Department of Neurology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 134 Calea Plevnei Str., 010242 Bucharest, Romania.; Department of Preclinical Disciplines, Faculty of Medicine, 'Titu Maiorescu' University, 031593 Bucharest, Romania., Chitimus DM; Department of Neurology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 134 Calea Plevnei Str., 010242 Bucharest, Romania., Sirbu CA; Department of Neurology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 134 Calea Plevnei Str., 010242 Bucharest, Romania.; Department of Medical-Surgical and Prophylactical Disciplines, Faculty of Medicine, 'Titu Maiorescu' University, 031593 Bucharest, Romania., Țânțu MM; Department of Health Care and Therapy, Faculty of Science, Physical Education and Informatics, Universty of Piteşti,110040 Pitești, Romania., Ghinescu MC; Department of Medical-Surgical and Prophylactical Disciplines, Faculty of Medicine, 'Titu Maiorescu' University, 031593 Bucharest, Romania., Anghel D; Department of Internal Medicine, 'Dr. Carol Davila' Central Military Emergency University Hospital, 134 Calea Plevnei Str., 010242 Bucharest, Romania., Ionita-Radu F; Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Str., 050474 Bucharest, Romania.; Department of Gastroenterology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 134 Calea Plevnei Str., 010242 Bucharest, Romania.
Jazyk: angličtina
Zdroj: Life (Basel, Switzerland) [Life (Basel)] 2022 Jan 07; Vol. 12 (1). Date of Electronic Publication: 2022 Jan 07.
DOI: 10.3390/life12010080
Abstrakt: Background: Secondary thrombotic thrombocytopenic purpura (TTP) due to interferon beta-1a intramuscular (im) treatment is an uncommon adverse effect with only a few cases in multiple sclerosis patients reported worldwide. TTP together with haemolytic uremic syndrome (HUS) are classic forms of thrombotic microangiopathy, characterized by small-vessel platelet micro-thrombi that manifest clinically in a similar manner. Most common signs and symptoms include bruises and ecchymosis, neurologic symptoms and renal impairment. Interferon beta-1a represents one of the first-line therapies for relapsing-remitting multiple sclerosis due to its accessibility and efficacy.
Case Presentation: A 36-year-old woman who was previously diagnosed with relapsing-remitting multiple sclerosis had received weekly intramuscular injections with beta-interferon-1a (Avonex 30 mcg). After 9 months of treatment, she presented bruises and ecchymosis on her limbs and torso, epistaxis, gingival bleeding aggravated within 48 h and a persistent headache that was non-responsive to common analgesics. Haematology tests revealed typical results for thrombotic microangiopathy, including severe thrombocytopenia (4000/mm 3 ) and microangiopathic haemolytic anaemia with frequent schistocytes on the peripheral blood smear. Once the beta-interferon administration was ceased and upon the initiation of methylprednisolone, the symptoms remitted.
Conclusions: In this case study, we portrayed the particular association between the remission phase of multiple sclerosis and the violent onset of interferon-induced thrombotic thrombocytopenic purpura.
Databáze: MEDLINE
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