Resumen
Introduction: Thrombotic thrombocytopenic purpura (TTP) is a rare and highly lethal microangiopathic disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and multi-organ involvement associated with neurological, renal, and systemic abnormalities. Objective: Diagnosing this condition is challenging, as treatment should not be delayed and must be initiated as soon as possible. The current gold standard for diagnosis is the presence of decreased ADAMTS-13 levels (<10%). Clinical observation: We present the case of a previously healthy 32-year-old male patient with petechiae and jaundice. Laboratory tests pointed to a diagnosis of thrombotic thrombocytopenic purpura (hemolytic anemia, severe thrombocytopenia, and low ADAMTS-13). He had a poor response to corticosteroids, and fresh frozen plasma was chosen, which proved effective. Conclusion: TTP is a rare hematological emergency.
Citas
1. Papakonstantinou, A., Kalmoukos. P., Mpalaska, A., Koravou, E.-E., Gavriilaki, E. ADAMTS13 in the New Era of TTP. Int J Mol Sci. 2024, July; 25(15): 8137. DOI: 10.3390/ijms25158137
2. Bouarich, H., Fernández Rodríguez, M.L., Pérez Del Valle, K., Díaz Crespo, F.J. Microangiopatías trombóticas. Med - Programa Form Médica Contin Acreditado. 2023, Junio; 13(82): 4831-4840. https://doi.org/10.1016/j.med.2023.06.009
3. Scully, M., Hunt, B.J., Benjamin, S., Liesner, R., Rose, P., Peyvandi, F., et al. Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopaties. British Journal of Haematology. Wiley Online Library. https://doi.org/10.1111/j.1365-2141.2012.09167.x
4. National Heart, Lung, and Blood Institute. Púrpura trombótica trombocitopénica (TTP) . Transtornos plaquetarios. 2022, Julio. https://www.nhlbi.nih.gov/es/salud/purpura-trombotica-trombocitopenica
5. Miltiadous, O. Hou, M., Bussel, J.B. Identifying and treating refractory ITP: difficulty in diagnosis and role of combination treatment. Blood, 2020, Feb.; 135(7): 472–490. doi: https://doi.org/10.1182/blood.2019003599
6. Stanley, M, Killeen, R.B., Michalski, J.M. Thrombotic Thrombocytopenic Purpura. Updated 2023 Apr 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025, Jan. https://www.ncbi.nlm.nih.gov/books/NBK430721/
7. Du, P., Cristarella, T., Goyer, C., Moride, Y. A Systematic Review of the Epidemiology and Disease Burden of Congenital and Immune-Mediated Thrombotic Thrombocytopenic Purpura. J Blood Med. 2024, Aug 15: 363-386. DOI: 10.2147/JBM.S464365
8. Cataland, S.R., Coppo, P., Scully, M., Lämmle, B. Thrombotic thrombocytopenic purpura: 100 years of research on Moschcowitz syndrome. Blood. 2024, Sep 12; 144(11): 1143-1152. DOI: 10.1182/blood.2023022277
9. Kubo, M., Matsumoto, M. Frontiers in pathophysiology and management of thrombotic thrombocytopenic purpura. Int J Hematol. 2023, Mar; 117(3): 331-340. DOI: 10.1007/s12185-023-03552-8
10. Matsumoto, M., Miyakawa, Y., Kokame, K., Ueda, Y., Wada, H., Higasa, S., et.al. Diagnostic and treatment guidelines for thrombotic thrombocytopenic purpura (TTP) in Japan 2023. Int J Hematol. 2023, Nov.; 118(5): 529-546. DOI: 10.1007/s12185-023-03657-0.
11. Trisolini, S.M., Laganà, A., Capria, S. Immune Thrombotic Thrombocytopenic Purpura: Pathophysiology, Diagnosis, Therapy and Open Issues. Mediterr J Hematol Infect Dis. 2024, Jul.; 16(1): e2024060. DOI: 10.4084/MJHID.2024.060
12. Lämmle, B. ADAMTS13 recovery in caplacizumab-treated TTP. Blood. 2024, May; 143(18): 1785-1786. DOI: 10.1182/blood.2024023862
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Copyright (c) 2025 Roger Antonio Sernaque Mechato, Percy Cruz Gonzales Morán, Andrea Paola Cruz Pérez

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