Early Relapse of Thrombotic Thrombocytopenic Purpura duringTherapeutic Plasma Exchange Associated with Acinetobacter anitratus Bacteremia
| Autor: | Elizabeth M. Kfoury Baz, Abdel Razzak A. Mikati, Nadim Kanj |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Thrombotic thrombocytopenic purpura Bacteremia Risk Assessment Gastroenterology Fatal Outcome Recurrence hemic and lymphatic diseases Internal medicine Humans Medicine Platelet Acinetobacter Plasma Exchange Purpura Thrombotic Thrombocytopenic business.industry Hematology Microangiopathic hemolytic anemia Middle Aged medicine.disease Connective tissue disease Anti-Bacterial Agents Schistocyte Treatment Outcome Neurologic manifestation Nephrology Immunology Plasmapheresis business Acinetobacter Infections |
| Zdroj: | Therapeutic Apheresis and Dialysis. 7:119-121 |
| ISSN: | 1744-9987 1744-9979 |
| DOI: | 10.1046/j.1526-0968.2003.00016.x |
| Popis: | Thrombotic thrombocytopenic purpura (TTP)/Hemolytic-uremic syndrome (HUS) is a syndrome characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, renal failure and neurologic manifestation. Almost all cases are idiopathic. However, secondary TTP/HUS associated with viral, bacterial and mycobacterial infections, drugs, connective tissue disease, solid tumors, bone marrow transplantation and pregnancy have been described. Early relapse associated with infection is a rare occurrence. The patient we report had a classic case of postdiarrheal TTP/HUS that responded to plasmapheresis but relapsed during treatment as reflected by the increased schistocytosis, decreased hematocrit, increased lactate dehydrogenase, and decreased platelet counts. This relapse may be attributed to Acinetobacter anitratus bacteremia, secondary to central line infection. Administration of antimicrobial treatment resulted initially in a mild improvement. However, this was followed by a fatal relapse. The importance of monitoring the possible bacterial colonization of an indwelling catheter is thus emphasized. |
| Databáze: | OpenAIRE |
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