RESUMEN
We are presenting a case of TTP with undetectable levels of ADAMTS 13 in a 39-year-old woman. Diagnosis of systemic lupus was evoked in the setting of thrombotic microangiopathy. The patient presented normal renal function but important neurological impairment. Treatment with daily plasmapheresis as well as Rituximab, cyclophosphamide as steroids was required to achieve clinical improvement.
Asunto(s)
Anemia Hemolítica/diagnóstico , Plaquetas/inmunología , Púrpura Trombocitopénica Trombótica/diagnóstico , Síndrome de Sjögren/tratamiento farmacológico , Adulto , Autoanticuerpos/sangre , Codeína/uso terapéutico , Ciclofosfamida/uso terapéutico , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Lupus Eritematoso Sistémico , Plasmaféresis , Púrpura Trombocitopénica Trombótica/inmunología , Inducción de Remisión , Rituximab/uso terapéuticoRESUMEN
We report a case of a 64-year-old man who, 44 days after starting treatment with prasugrel, presented with severe thrombocytopenia, anaemia, renal failure, and severe ADAMTS13 activity deficiency, along with a high titer of autoantibodies to this protease. LEARNING POINTS: Drug-induced TTP is a rare condition and difficult to diagnose.Decreased activity of ADAMTS13, unusual in drug-induced TTP, was present in this case.