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The Hemostatic Conundrum of Thrombotic Thrombocytopenic Purpura: a Case Report by Evashin Pillay, Susan Louw

Background: In thrombotic thrombocytopenic purpura (TTP), von Willebrand factor (VWF)-platelet rich thrombi form in the microvasculature with ischemia in vital organs. The pathogenesis relates to deficiency of the VWF cleaving protease, ADAMTS-13.
Methods: A case study of a 58-year-old female with previously undiagnosed HIV (human immunodeficiency virus) infection, left hemiparesis, and soft tissue hemorrhages.
Results: Investigations revealed microangiopathic hemolytic anemia and a left basal ganglia infarct on magnetic resonance imaging (MRI). A diagnosis of acquired, HIV-related TTP was made and therapeutic plasma exchange and antiretroviral therapy were initiated.
Conclusions: The combined thrombotic and hemorrhagic manifestations of TTP pose therapeutic challenges.

DOI: 10.7754/Clin.Lab.2018.181222