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Marked Improvement in Refractory TTP Directly after H. pylori Eradication Therapy.

Gringauz I, Carmel-Neiderman NN, Mangel T, Portnoy O, Segal G, Goren I - Case Rep Hematol (2016)

Bottom Line: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder involving thrombotic microangiopathy and is characterized by increased platelet aggregation throughout the body.The TTP was highly resistant to medical therapy; however the patient underwent complete resolution of her TTP following H. pylori eradication.We conclude that acquired TTP may be triggered by H. pylori infection and that treating the underlying infection may play a role in improving TTP's outcome in some patients, especially when disease is refractory to medical therapy.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine Ward T, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.

ABSTRACT
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder involving thrombotic microangiopathy and is characterized by increased platelet aggregation throughout the body. Acquired TTP can be triggered by a variety of conditions including infections. We hereby describe a case report of an 81-year-old female presenting to the internal medicine department with TTP and active chronic gastritis, positive for Helicobacter pylori (H. pylori) on biopsy. The TTP was highly resistant to medical therapy; however the patient underwent complete resolution of her TTP following H. pylori eradication. We conclude that acquired TTP may be triggered by H. pylori infection and that treating the underlying infection may play a role in improving TTP's outcome in some patients, especially when disease is refractory to medical therapy.

No MeSH data available.


Related in: MedlinePlus

A CT slice of the left upper abdomen showing a large filling defect (arrow) with thickened folds at the cardia of the stomach (S).
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fig1: A CT slice of the left upper abdomen showing a large filling defect (arrow) with thickened folds at the cardia of the stomach (S).

Mentions: Clinical Course. A diagnosis of TTP was made and the patient was started on plasmapheresis via a femoral catheter. Steroid treatment was initiated. In order to rule out underling malignancy a computed tomography (CT) scan of the chest and abdomen was performed and showed an intraluminal thickening of 3.5 cm size in the stomach (Figure 1). Further PET CT supported the findings demonstrating an unusual thickening of the gastric cardia with hypermetabolic activity in the distal third of the esophagus, suggesting a process with an increased metabolic activity.


Marked Improvement in Refractory TTP Directly after H. pylori Eradication Therapy.

Gringauz I, Carmel-Neiderman NN, Mangel T, Portnoy O, Segal G, Goren I - Case Rep Hematol (2016)

A CT slice of the left upper abdomen showing a large filling defect (arrow) with thickened folds at the cardia of the stomach (S).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835621&req=5

fig1: A CT slice of the left upper abdomen showing a large filling defect (arrow) with thickened folds at the cardia of the stomach (S).
Mentions: Clinical Course. A diagnosis of TTP was made and the patient was started on plasmapheresis via a femoral catheter. Steroid treatment was initiated. In order to rule out underling malignancy a computed tomography (CT) scan of the chest and abdomen was performed and showed an intraluminal thickening of 3.5 cm size in the stomach (Figure 1). Further PET CT supported the findings demonstrating an unusual thickening of the gastric cardia with hypermetabolic activity in the distal third of the esophagus, suggesting a process with an increased metabolic activity.

Bottom Line: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder involving thrombotic microangiopathy and is characterized by increased platelet aggregation throughout the body.The TTP was highly resistant to medical therapy; however the patient underwent complete resolution of her TTP following H. pylori eradication.We conclude that acquired TTP may be triggered by H. pylori infection and that treating the underlying infection may play a role in improving TTP's outcome in some patients, especially when disease is refractory to medical therapy.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine Ward T, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.

ABSTRACT
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder involving thrombotic microangiopathy and is characterized by increased platelet aggregation throughout the body. Acquired TTP can be triggered by a variety of conditions including infections. We hereby describe a case report of an 81-year-old female presenting to the internal medicine department with TTP and active chronic gastritis, positive for Helicobacter pylori (H. pylori) on biopsy. The TTP was highly resistant to medical therapy; however the patient underwent complete resolution of her TTP following H. pylori eradication. We conclude that acquired TTP may be triggered by H. pylori infection and that treating the underlying infection may play a role in improving TTP's outcome in some patients, especially when disease is refractory to medical therapy.

No MeSH data available.


Related in: MedlinePlus