Thrombotic Thrombocytopenic Purpura: A Rare Cause of Severe Acute Kidney Injury

Thrombotic microangiopathy (TMA) is a serious and potentially fatal disorder, especially if there is a delay in diagnosis and appropriate treatment. Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are the two main forms of TMA. Although severe acute kidney injury (AKI)...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-04, Vol.14 (4), p.e24221
Main Authors: Najar, Hatem, Tuider, Laurene, Kukkar, Vinita, Quasem, Mohammad
Format: Article
Language:English
Subjects:
Anemia
Apheresis
Blood
Blood platelets
Case reports
Creatinine
Dehydrogenases
Health services
Hematology
Hemodialysis
Hemoglobin
Hospitals
Immunotherapy
Internal Medicine
Kidneys
Monoclonal antibodies
Nephrology
Patients
Penis
Purpura
Thrombocytopenia
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Summary:Thrombotic microangiopathy (TMA) is a serious and potentially fatal disorder, especially if there is a delay in diagnosis and appropriate treatment. Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are the two main forms of TMA. Although severe acute kidney injury (AKI) is a common manifestation of TMA, it remains rarely described in reported TTP cases. We present a rare case of TTP in a 76-year-old African American male who presented with severe AKI (stage 3) and uremic symptoms. Early diagnosis and prompt treatment of TTP with plasmapheresis followed by rituximab and caplacizumab were associated with the resolution of the AKI and avoidance of hemodialysis. This case highlights the need to consider TTP as a possible diagnosis even in the setting of severe AKI.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.24221