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Akpinar S, Tekgunduz E, Esen R, Yilmaz M, Karakus V, Vural F, Gediz F, Aydogdu I, Kaynar L, Goker H, Kelkitli E, Ayyildiz O, Demirkan F. Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study. Transfus Apher Sci 2022; 61:103365. [PMID: 35120823 DOI: 10.1016/j.transci.2022.103365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Thrombotic microanjiopathy (TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter study aimed to define the distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as having acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6-10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 80 patients (women: 50; man: 30) with a median age of 48 (20-74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 29 (36.2 %), 22 (27.5 %), 23 (28.8 %) and 6 (7.5 %) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance.
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Affiliation(s)
- Seval Akpinar
- Namık Kemal University Medical School, Department of Internal Medicine, Division of Hematology, Tekirdag, Turkey.
| | - Emre Tekgunduz
- Memorial Bahcelievler Hospital Adult Hematology and BMT Clinic, Istanbul, Turkey
| | - Ramazan Esen
- Yuzuncu Yıl University Medical School, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Mehmet Yilmaz
- Sanko University Medical School, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Volkan Karakus
- Mugla Sıtkı Kocman University Medical School, Department of Internal Medicine, Division of Hematology, Mugla, Turkey
| | - Filiz Vural
- Ege University Medical School, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Fusun Gediz
- Medicalpark Hospital, Hematology and BMT Clinic, Izmir, Turkey
| | - Ismet Aydogdu
- Celal Bayar University Medical School, Department of Internal Medicine, Division of Hematology, Manisa, Turkey
| | - Leylagul Kaynar
- Erciyes University Medical School, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Hakan Goker
- Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Engin Kelkitli
- Ondokuz Mayis University Medical School, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Orhan Ayyildiz
- Dicle University Medical School, Department of Internal Medicine, Division of Hematology, Diyarbakir, Turkey
| | - Fatih Demirkan
- Dokuz Eylul University Medical School, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
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Akpınar S, Tekgunduz E, Erkurt MA, Esen R, Yılmaz M, Karakus V, Vural F, Gediz F, Aydogdu I, Kaynar L, Korkmaz S, Goker H, Kelkitli E, Ayyıldız O, Demirkan F. Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study. Transfus Apher Sci 2021:103312. [PMID: 34799244 DOI: 10.1016/j.transci.2021.103312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Thrombotic microangiopathy(TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter (n:18) study aimed to define distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for a presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6-10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 97 patients (female: 60; male: 30) with a median age of 48 (18-74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 32 (33 %), 33 (34 %), 26 (27 %) and 6 (6%) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance.
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Affiliation(s)
- Seval Akpınar
- Namık Kemal University Medical School, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey.
| | - Emre Tekgunduz
- Memorial Bahcelievler Hospital Adult Hematology and BMT Clinic, Istanbul, Turkey
| | - Mehmet Ali Erkurt
- Inonu University Medical School, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ramazan Esen
- Yuzuncu Yıl University Medical School, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Mehmet Yılmaz
- Sanko University Medical School, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Volkan Karakus
- Mugla Sıtkı Kocman University Medical School, Department of Internal Medicine, Division of Hematology, Mugla, Turkey
| | - Filiz Vural
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Fusun Gediz
- Medicalpark Hospital, Hematology and BMT Clinic, Izmir, Turkey
| | - Ismet Aydogdu
- Celal Bayar University Medical Faculty, Department of Internal Medicine, Division of Hematology, Manisa, Turkey
| | - Leylagul Kaynar
- Erciyes University Faculty of Medicine, Department of Hematology, Kayseri, Turkey
| | - Serdal Korkmaz
- University of Health Sciences, Kayseri City Training and Research Hospital, Department of Hematology, Kayseri, Turkey
| | - Hakan Goker
- Hacettepe University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Engin Kelkitli
- Ondokuz Mayis University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakir, Turkey
| | - Fatih Demirkan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, Izmir, Turkey
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Gangemi A, Durgam S, Cristoforo Giulianotti P. Acute thrombotic thrombocytopenic purpura after sleeve gastrectomy: a case report and review of the literature. Surg Obes Relat Dis 2016; 12:e80-e82. [PMID: 27989525 DOI: 10.1016/j.soard.2016.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/11/2016] [Accepted: 09/20/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Antonio Gangemi
- Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, Chicago, Illinois.
| | - Samarth Durgam
- Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, Chicago, Illinois
| | - Pier Cristoforo Giulianotti
- Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, Chicago, Illinois
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