Clinical and biological features of the pregnancy-onset TTP boot in 42 patients
Patient no. . | Previous pregnancies (fetal loss), n . | Current pregnancy-associated TTP . | |||||
---|---|---|---|---|---|---|---|
Term (WG) . | Other associated context . | Anti-ADAMTS13 IgG/inhibitor . | Treatment . | Mother outcome . | Baby outcome . | ||
1 | 0 | 1 | Ovarian stimulation (IVF) | +/+ | PT/steroids | Good | Miscarriage |
2 | 1 | 1 | Ovarian stimulation (IVF) | +/− | PT/steroids | Good | Miscarriage |
3 | 0 | 4 | Thyroitidis | −/− | PT/steroids/antihypertensive drugs | Good | Miscarriage |
4 | 1 (1) | 4 | +/− | PT/steroids | Good | Miscarriage | |
5* | 0 | 10 | −/− | PT | Good | Miscarriage | |
6 | 0 | 11 | Urinary infection | +/+ | PT/steroids | Good | Miscarriage |
7 | 0 | 11 | Viral infection | +/− | PT until delivery (38 WG) | Good | Good |
8* | 0 | 12 | −/− | PT | Good | Miscarriage | |
9 | 0 | 12 | +/+ | PT/steroids/aspirin | Good | Miscarriage | |
10 | 0 | 12 | HIV | +/− | PT/Rituximab | Neurologic sequellae | Miscarriage |
11 | 1 | 16 | +/+ | PT/steroids | Good | IUFD | |
12 | 0 | 20 | +/+ | PT | Good | IUFD | |
13 | 0 | 23 | +/+ | PT | Good | IUFD | |
14 | 0 | 24 | Influenza infection | −/+ | PT | Good | IUFD |
15 | 0 | 24 | Lupus, APLS | +/− | PT/steroids/rituximab | Good | IUFD |
16* | 0 | 25 | −/− | PT | Good | Death at day 15 | |
17 | 0 | 25 | −/+ | PT | Good | IUFD | |
18 | 0 | 25 | −/+ | PT | Good | IUFD | |
19 | 0 | 25 | −/+ | PT/steroids | Good | IUFD | |
20 | 0 | 25 | −/− | PT/steroids/heparin | Good | IUFD | |
21* | 0 | 26 | −/− | PT | Good | IUFD | |
22* | 0 | 27 | −/− | PT | Good | IUFD | |
23 | 2 | 28 | +/+ | Platelet concentrates | Death | IUFD | |
24* | 0 | 30 | −/− | Good | Death at day 40 | ||
25 | 0 | 31 | −/− | PT | Good | Good | |
26 | 2 (1) | 31 | Thyroitidis | −/− | PT/steroids | Good | Good |
27 | 0 | 32 | −/− | PT/steroids | Good | IUFD | |
28* | 0 | 33 | +/+ | PT | Good | Good | |
29 | 0 | 35 | −/+ | PT/steroids | Good | Good | |
30* | 0 | 35 | −/− | Aspirin | Good | Good | |
31 | 2 | 36 | Auto-immune thrombocytopenic purpura | −/+ | Platelet concentrates/steroids/IV Ig | Death | Good |
32* | 0 | 36 | −/− | PT | Good | Good | |
33 | 7 (3) | 36 | −/− | PT | Good | Good | |
34 | 0 | 37 | −/− | PT | Good | Good | |
35* | 0 | 38 | −/− | PT/steroids | Good | Good | |
36 | 1 | PP | +/+ | PT | Good | Good | |
37 | 0 | PP | −/− | PT | Good | Good | |
38 | 0 | PP | Sepsis | −/− | PT | Good | Good |
39 | 4 | PP | +/− | PT/steroids/rituximab/splenectomy | Neurologic sequellae | Good | |
40 | 0 | PP | Viral infection | +/− | PT/steroids/cyclophosphamide | Renal sequellae | Good |
41 | 0 | PP | −/+ | PT | Good | Good | |
42 | 3 | PP | Viral infection | −/− | PT | Good | Good |
Patient no. . | Previous pregnancies (fetal loss), n . | Current pregnancy-associated TTP . | |||||
---|---|---|---|---|---|---|---|
Term (WG) . | Other associated context . | Anti-ADAMTS13 IgG/inhibitor . | Treatment . | Mother outcome . | Baby outcome . | ||
1 | 0 | 1 | Ovarian stimulation (IVF) | +/+ | PT/steroids | Good | Miscarriage |
2 | 1 | 1 | Ovarian stimulation (IVF) | +/− | PT/steroids | Good | Miscarriage |
3 | 0 | 4 | Thyroitidis | −/− | PT/steroids/antihypertensive drugs | Good | Miscarriage |
4 | 1 (1) | 4 | +/− | PT/steroids | Good | Miscarriage | |
5* | 0 | 10 | −/− | PT | Good | Miscarriage | |
6 | 0 | 11 | Urinary infection | +/+ | PT/steroids | Good | Miscarriage |
7 | 0 | 11 | Viral infection | +/− | PT until delivery (38 WG) | Good | Good |
8* | 0 | 12 | −/− | PT | Good | Miscarriage | |
9 | 0 | 12 | +/+ | PT/steroids/aspirin | Good | Miscarriage | |
10 | 0 | 12 | HIV | +/− | PT/Rituximab | Neurologic sequellae | Miscarriage |
11 | 1 | 16 | +/+ | PT/steroids | Good | IUFD | |
12 | 0 | 20 | +/+ | PT | Good | IUFD | |
13 | 0 | 23 | +/+ | PT | Good | IUFD | |
14 | 0 | 24 | Influenza infection | −/+ | PT | Good | IUFD |
15 | 0 | 24 | Lupus, APLS | +/− | PT/steroids/rituximab | Good | IUFD |
16* | 0 | 25 | −/− | PT | Good | Death at day 15 | |
17 | 0 | 25 | −/+ | PT | Good | IUFD | |
18 | 0 | 25 | −/+ | PT | Good | IUFD | |
19 | 0 | 25 | −/+ | PT/steroids | Good | IUFD | |
20 | 0 | 25 | −/− | PT/steroids/heparin | Good | IUFD | |
21* | 0 | 26 | −/− | PT | Good | IUFD | |
22* | 0 | 27 | −/− | PT | Good | IUFD | |
23 | 2 | 28 | +/+ | Platelet concentrates | Death | IUFD | |
24* | 0 | 30 | −/− | Good | Death at day 40 | ||
25 | 0 | 31 | −/− | PT | Good | Good | |
26 | 2 (1) | 31 | Thyroitidis | −/− | PT/steroids | Good | Good |
27 | 0 | 32 | −/− | PT/steroids | Good | IUFD | |
28* | 0 | 33 | +/+ | PT | Good | Good | |
29 | 0 | 35 | −/+ | PT/steroids | Good | Good | |
30* | 0 | 35 | −/− | Aspirin | Good | Good | |
31 | 2 | 36 | Auto-immune thrombocytopenic purpura | −/+ | Platelet concentrates/steroids/IV Ig | Death | Good |
32* | 0 | 36 | −/− | PT | Good | Good | |
33 | 7 (3) | 36 | −/− | PT | Good | Good | |
34 | 0 | 37 | −/− | PT | Good | Good | |
35* | 0 | 38 | −/− | PT/steroids | Good | Good | |
36 | 1 | PP | +/+ | PT | Good | Good | |
37 | 0 | PP | −/− | PT | Good | Good | |
38 | 0 | PP | Sepsis | −/− | PT | Good | Good |
39 | 4 | PP | +/− | PT/steroids/rituximab/splenectomy | Neurologic sequellae | Good | |
40 | 0 | PP | Viral infection | +/− | PT/steroids/cyclophosphamide | Renal sequellae | Good |
41 | 0 | PP | −/+ | PT | Good | Good | |
42 | 3 | PP | Viral infection | −/− | PT | Good | Good |
Patient was diagnosed retrospectively with hereditary TTP (Upshaw-Schulman syndrome).
WG indicates weeks of gestation; IVF, in vitro fertilization; and IUFD, intrauterine fetal death.