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Ibn Idris Rodwan AA, Ahmed Elmansour OK, Ahmed AFE, Elagib EM, Ahmed Eltahir NI, Hassan A, El-Sadig SM, Mohammed AGAA, Awadalla HH, Mohammed AA, Adam Essa ME. A Rare Association of Thrombotic Thrombocytopenic Purpura with Systemic Lupus Erythematosus in a Sudanese Woman: Case Report. J Blood Med 2021; 12:945-949. [PMID: 34785968 PMCID: PMC8579963 DOI: 10.2147/jbm.s334689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/13/2021] [Indexed: 11/23/2022] Open
Abstract
Thrombotic thrombocytopenic purpura (TTP) is an uncommon life-threatening condition characterized by hemolytic disorders. The coexistence of systemic lupus erythematosus (SLE) with TTP is extremely rare, although Africans are at increased risk due to inherited risk factors. This report describes a rare clinical manifestation of TTP associated with SLE in a Sudanese patient. A 41-year-old Sudanese woman presented to the emergency department with symptoms and features that were suggestive of malaria, for which she had been treated accordingly. However, a few days later she complained of fever, and was found to have a body temperature of 39.5°C, jaundice, anemia, and thrombocytopenia. Soon after admission, she developed confusion and unrecordable blood pressure. After the patient had stabilized, clinical assessment, immune-system investigation (antinuclear antibody profile, complements, blood panel), and imaging revealed a diagnosis of TTP associated with SLE. The patient received imipenem 500 mg, five sessions of plasmapheresis (60 mL/kg), methylprednisolone 1 g pulse for 3 days, and rituximab 375 mg/week. Three weeks later, the patient was discharged after her condition had improved, and she is now on regular follow-up.
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Affiliation(s)
| | - Osama Khder Ahmed Elmansour
- Department of Rheumatology, Sudan Medical Specialization Council, Khartoum, Sudan.,Department of Rheumatology, Faculty of Medicine, Shendi University, Shendi, Sudan
| | - Amar F Eldow Ahmed
- Department of Internal Medicine, Wayne State University, Detroit, MI, USA
| | - Elnour Mohammed Elagib
- Department of Rheumatology, Sudan Medical Specialization Council, Khartoum, Sudan.,Department of Rheumatology, Omdurman Military Hospital, Khartoum, Sudan
| | - Noha Ibrahim Ahmed Eltahir
- Department of Rheumatology, Omdurman Military Hospital, Khartoum, Sudan.,Department of Medicine, Faculty of Medicine, Karary University, Khartoum, Sudan
| | - Abubaker Hassan
- Department of Clinical Medicine, Medical and Cancer Research Institute, Nyala, Sudan
| | - Sara M El-Sadig
- Department of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Huyam H Awadalla
- Department of Internal Medicine, Detroit Medical Centre, Detroit, MI, USA
| | | | - Mohammed Elmujtba Adam Essa
- Department of Clinical Medicine, Medical and Cancer Research Institute, Nyala, Sudan.,Faculty of Medicine, Al Fashir University, Al Fashir, Sudan
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