The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review
Abstract This is a case series of three patients in our hospital system who developed acquired thrombotic thrombocytopenic purpura (aTTP) after testing positive for COVID‐19 infection. Two patients had acute COVID‐19 infections, and one had COVID‐19 IgG antibodies consistent with prior COVID‐19 infe...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-11-01
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| Series: | eJHaem |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jha2.577 |
| _version_ | 1797666902732963840 |
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| author | Neumann Melissa Singhal Adit Habibullah Junaid Dhar Sean |
| author_facet | Neumann Melissa Singhal Adit Habibullah Junaid Dhar Sean |
| author_sort | Neumann Melissa |
| collection | DOAJ |
| description | Abstract This is a case series of three patients in our hospital system who developed acquired thrombotic thrombocytopenic purpura (aTTP) after testing positive for COVID‐19 infection. Two patients had acute COVID‐19 infections, and one had COVID‐19 IgG antibodies consistent with prior COVID‐19 infection. Twelve additional cases of aTTP after COVID‐19 infection were found in the literature. COVID‐19 creates alterations in the vWF‐ADAMTS‐13 axis with reduced ADAMTS‐13 in acute illness that may lead those patients who are predisposed into fulminant aTTP. Further genetic studies are necessary to uncover why some patients with COVID‐19 can have concurrent aTTP. For those with a prior COVID‐19 infection, molecular mimicry with autoantibodies to ADAMTS‐13 is likely the predominant trigger, but having an underlying predisposition (prior episode of TTP, genetic predisposition to autoimmune conditions, or breast cancer history) creates an environment that could be a possible trigger for aTTP. |
| first_indexed | 2024-03-11T20:06:20Z |
| format | Article |
| id | doaj.art-479c8c77a72e44fcacffc279e638b4ec |
| institution | Directory Open Access Journal |
| issn | 2688-6146 |
| language | English |
| last_indexed | 2024-03-11T20:06:20Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj.art-479c8c77a72e44fcacffc279e638b4ec2023-10-03T16:50:47ZengWileyeJHaem2688-61462022-11-01341358136410.1002/jha2.577The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and reviewNeumann Melissa0Singhal Adit1Habibullah Junaid2Dhar Sean3Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Manhasset New York USADonald and Barbara Zucker School of Medicine at Hofstra/Northwell Manhasset New York USADivision of Hospital Medicine and Division of Pulmonary Critical Care and Sleep Medicine Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Manhasset New York USADivision of Hospital Medicine and Division of Pulmonary Critical Care and Sleep Medicine Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Manhasset New York USAAbstract This is a case series of three patients in our hospital system who developed acquired thrombotic thrombocytopenic purpura (aTTP) after testing positive for COVID‐19 infection. Two patients had acute COVID‐19 infections, and one had COVID‐19 IgG antibodies consistent with prior COVID‐19 infection. Twelve additional cases of aTTP after COVID‐19 infection were found in the literature. COVID‐19 creates alterations in the vWF‐ADAMTS‐13 axis with reduced ADAMTS‐13 in acute illness that may lead those patients who are predisposed into fulminant aTTP. Further genetic studies are necessary to uncover why some patients with COVID‐19 can have concurrent aTTP. For those with a prior COVID‐19 infection, molecular mimicry with autoantibodies to ADAMTS‐13 is likely the predominant trigger, but having an underlying predisposition (prior episode of TTP, genetic predisposition to autoimmune conditions, or breast cancer history) creates an environment that could be a possible trigger for aTTP.https://doi.org/10.1002/jha2.577ADAMTSCOVID‐19PLASMICthrombotic microangiopathythrombotic thrombocytopenic purpura |
| spellingShingle | Neumann Melissa Singhal Adit Habibullah Junaid Dhar Sean The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review eJHaem ADAMTS COVID‐19 PLASMIC thrombotic microangiopathy thrombotic thrombocytopenic purpura |
| title | The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review |
| title_full | The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review |
| title_fullStr | The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review |
| title_full_unstemmed | The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review |
| title_short | The perfect storm: Thrombotic thrombocytopenic purpura (TTP) associated with COVID‐19, a clinical case series and review |
| title_sort | perfect storm thrombotic thrombocytopenic purpura ttp associated with covid 19 a clinical case series and review |
| topic | ADAMTS COVID‐19 PLASMIC thrombotic microangiopathy thrombotic thrombocytopenic purpura |
| url | https://doi.org/10.1002/jha2.577 |
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