Early relapse of thrombotic thrombocytopenic purpura during therapeutic plasma exchange associated with Acinetobacter anitratus bacteremia

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, bacteria...

Full description

Saved in:
Bibliographic Details
Published in:Therapeutic apheresis and dialysis 2003-02, Vol.7 (1), p.119-121
Main Authors: Kanj, Nadim A, Mikati, Abdel Razzak A, Kfoury Baz, Elizabeth M
Format: Article
Language:English
Subjects:
Acinetobacter - isolation & purification
Acinetobacter Infections - complications
Acinetobacter Infections - diagnosis
Acinetobacter Infections - drug therapy
Anti-Bacterial Agents - therapeutic use
Bacteremia - complications
Bacteremia - diagnosis
Bacteremia - drug therapy
Fatal Outcome
Humans
Male
Middle Aged
Plasma Exchange - methods
Purpura, Thrombotic Thrombocytopenic - complications
Purpura, Thrombotic Thrombocytopenic - diagnosis
Purpura, Thrombotic Thrombocytopenic - therapy
Recurrence
Risk Assessment
Time Factors
Treatment Outcome
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1744-9979
DOI:10.1046/j.1526-0968.2003.00016.x