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Immune -mediated thrombotic thrombocytopenic purpura (ITTP) is a rare thrombotic micro- vascular disease (TMA), is caused by autoantibodies to ADAMTS13 metalloprotease
Immune -mediated thrombotic thrombocytopenic purpura (ITTP) is a rare thrombotic micro- vascular disease (TMA), is caused by autoantibodies to ADAMTS13 metalloprotease
To date, there are no data on the use of caplacizumab to treat pregnancy-related iTTP
The patient was diagnosed with iTTP 13 years before the attack
Figure: (A) Timeline of platelets, LDH levels, ADAMTS13 activity and anti-ADAMTS13 antibodies related to disease onset (day 0) and treatment
Figure: (A) Timeline of platelets, LDH levels, ADAMTS13 activity and anti-ADAMTS13 antibodies related to disease onset (day 0) and treatment
hypertension
Vaginal delivery is advantageous, and intrauterine fetal killing is performed by intracardiac potassium injection before delivery at the request of the patient
With the help of LC-HR-MS/MS analysis, transplacental transfer of caplacizumab was recorded (see supplementary materials for the method)
1D prevention
In conclusion, the patient's caplacizumab treatment seems to be safe and effective, and the platelet count quickly returned to normal within three days
Based on experience, what lessons can be learned for iTTP cases in the first trimester in the future? First, iTTP is a devastating disease that affects mothers and fetuses, with a high risk of adverse consequences
Based on experience, what lessons can be learned for iTTP cases in the first trimester in the future? In individual cases, it seems reasonable to start caplacizumab therapy quickly and firmly to prevent thrombotic microangiopathies
Original source:
Kühne, L.
Kühne, L.
, Völker, LA, Hagmann, H.
, Hägele, H.
, Osterholt, T.
, Eichenauer, DA, Thomas, A.
, Breuer, J.
, Grüttner, B.
, Gottschalk, I.
, Kann, M.
, Benzing, T.
, Thevis, M.
, Müller, AM and Brinkkoetter, PT (2021), First use of the anti-VWF nanobody caplacizumab to treat iTTP in pregnancy.
Br J Haematol.
https://doi.
org /10.
1111/bjh.
17833
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