ASFA Category IV becomes Category I: Idiopathic thrombotic thrombocytopenic purpura in a patient with presumed gemcitabine-induced thrombotic microangiopathy.

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2018-06

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Abstract

In the implementation of American Society for Apheresis national guidelines, the decision for therapeutic plasma exchange may be confounded by a clinical presentation that fits both a Category I and IV designation. We report the case of a 45-year-old female who presented with concern for a Category IV disorder, gemcitabine-induced thrombotic microangiopathy, and was ultimately diagnosed with a Category I disorder, idiopathic thrombotic thrombocytopenic purpura. This case highlights the importance of ruling out idiopathic TTP by a thorough evaluation for ADAMTS13 activity and inhibitor, even when an alternate thrombotic microangiopathy diagnosis may be likely.

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10.1002/jca.21590

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Bittar, Peter G, Myles S Nickolich and Oluwatoyosi A Onwuemene (2018). ASFA Category IV becomes Category I: Idiopathic thrombotic thrombocytopenic purpura in a patient with presumed gemcitabine-induced thrombotic microangiopathy. Journal of clinical apheresis, 33(3). pp. 423–426. 10.1002/jca.21590 Retrieved from https://hdl.handle.net/10161/27021.

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Onwuemene

Oluwatoyosi Adefunke Onwuemene

Associate Professor of Medicine

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