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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Thrombocytopenic purpura (TTP) is a rare, potentially fatal pathology characterized by microangiopathic thrombotic syndrome and caused by an acute protease deficiency of von Willebrand factor, ADAMTS13. Moreover, ADAMTS13 deficiency promotes microthrombosis led by the persistence of ultra-large VWF multimers in the blood circulation. According to the few studies involving pregnant participants, the heterogeneity of manifestations has made this pathology difficult to diagnose, with an unexpected occurrence and increased risk of maternal and fetal morbidity and mortality. We reported on the case of a 28-year-old pregnant woman with an obstetric score of G2P0 who presented to the obstetrics and gynecology department of our clinic with the complaint of minimal vaginal bleeding. The evolution of our case was severe and life-threatening, a “race against the clock”, with our goal being to emphasize the importance and difficulty of diagnosing TTP in the absence of specific symptomatology. We faced a lack of technological support for a correct and complete diagnosis, and the first manifestation of this disease was the intrauterine death of the fetus. After completing all the necessary procedures, the placental tissue was sent for further histopathological evaluation. We highlighted the importance of monitoring ADAMTS13 for relapses monthly, with prophylaxis being essential for maternal and fetal mortality and morbidity.

Details

Title
A Race against the Clock: A Case Report and Literature Review Concerning the Importance of ADAMTS13 Testing in Diagnosis and Management of Thrombotic Thrombocytopenic Purpura during Pregnancy
Author
Mitranovici, Melinda Ildiko 1 ; Pușcașiu, Lucian 2 ; Oală, Ioan Emilian 1 ; Petre, Izabella 3 ; Craina, Marius Lucian 3 ; Mager, Antonia Rebeka 4 ; Vasile, Kinga 5 ; Chiorean, Diana Maria 6 ; Adrian-Horațiu Sabău 7 ; Sabin Gligore Turdean 6 ; Ovidiu Simion Cotoi 7 

 Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania; [email protected] 
 Department of Obstetrics and Gynecology, County Emergency Hospital, University of Medicine and Pharmacy Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania; [email protected] 
 Department of Obstetrics and Gynecology, Victor Babeș University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; [email protected] (I.P.); [email protected] (M.L.C.) 
 Department of Pathology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania; [email protected] 
 Department of Hematology, Emergency County Hospital Deva, 1 Decembrie Street, 330005 Deva, Romania; [email protected] 
 Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania; [email protected] (D.M.C.); [email protected] (A.-H.S.); [email protected] (S.G.T.); [email protected] (O.S.C.) 
 Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania; [email protected] (D.M.C.); [email protected] (A.-H.S.); [email protected] (S.G.T.); [email protected] (O.S.C.); Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania 
First page
1559
Publication year
2022
Publication date
2022
Publisher
MDPI AG
e-ISSN
20754418
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2693972986
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.