Case report of thrombotic thrombocytopenic purpura during pregnancy with a review of the relevant research

Abstract

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a syndrome characterized by widespread blood vessel clotting and bleeding. It can affect individuals of any age but is more commonly observed in females, particularly during pregnancy. Pregnancy combined with TTP is a critical and rapidly progressing condition that is often misdiagnosed as an obstetric disorder like severe preeclampsia or HELLP syndrome. To deepen the understanding of TTP during pregnancy with the help of a clinical case.

Patient concerns: A 20-year-old patient, is pregnancy 1 birth 0, 32 weeks dated by her last menstrual period, presented chest tightness, and shortness of breath after physical activity for 3 days.

Diagnoses: TTP.

Interventions: At present, there are no preventive measures. Timely diagnosis and treatment are useful. Plasma exchange and treat to the patient hinder autoantibodies, such as gamma globulin, methylprednisolone, rituximab, and cyclosporine were effective.

Outcomes: The patient exhibited stable vital signs, normal examination results, and experienced no complications. We continued to monitor her progress after she was discharged.

Lessons subsections: The acute onset of TTP is often associated with pregnancy, as it is a triggering factor. Timely identification, accurate diagnosis, and a comprehensive treatment approach involving plasma exchange, immunosuppressants, and the termination of pregnancy can lead to remission and a favorable outlook for the majority of patients.

Figure 1.

Time course of platelet count and hemoglobin concentration during treatment. The vertical lines represent plasma exchange, the blue line represents the platelet count (left y axis), and the red line represents the hemoglobin concentration (right y axis).

Figure 2.

Placental umbilical cord histopathology (HE ×40).

Figure 3.

Flow chart of reported case.