Thrombotic thrombocytopenic purpura with Graves' disease during pregnancy

A Case of Thrombotic Thrombocytopenic Purpura Possibly Induced by Graves' Disease

Thrombotic thrombocytopenic purpura (TTP) has historically been diagnosed with a pentad of features, i.e., thrombocytopenia, micro-angiopathic hemolytic anemia (MAHA), fever, neurological abnormalities, and kidney failure. Traditionally, TTP cases have been described in healthy adults. However, their association with autoimmune diseases is now well documented in the literature. There is limited availability of literature on the association between TTP and Graves' disease (GD). Here, we report a case of an adult female, a known case of Graves' disease, who has now been diagnosed with an acquired case of TTP. The presence of MAHA associated with thrombocytopenia was considered a clinical diagnosis of TTP and the patient immediately underwent plasma exchange (PEX), which led to the resolution of complaints. Hyperthyroidism cases should be adequately followed up as clinical severity could lead to the emergence of TTP.