4.8 Article

Recombinant ADAMTS13 for Hereditary Thrombotic Thrombocytopenic Purpura

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 387, Issue 25, Pages 2356-2361

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa2211113

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Funding

  1. Swiss National Science Foundation
  2. [310030-185233]

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A diagnosis of hereditary thrombotic thrombocytopenic purpura (TTP) was made in a pregnant woman at 30 weeks' gestation. Her condition did not respond to plasma exchange, but recombinant ADAMTS13 normalized her platelet count.
A 27-year-old patient with a history of severe obstetrical complications and arterial thrombosis received a diagnosis of hereditary thrombotic thrombocytopenic purpura (TTP) due to severe ADAMTS13 deficiency when she presented with an acute episode in the 30th week of her second pregnancy. When the acute episode of hereditary TTP became plasma-refractory and fetal death was imminent, weekly injections of recombinant ADAMTS13 at a dose of 40 U per kilogram of body weight were initiated. The patient's platelet count normalized, and the growth of the fetus stabilized. At 37 weeks 1 day of gestation, a small-for-gestational-age boy was delivered by cesarean section. At the time of this report, the patient and her son were well, and she continued to receive injections of recombinant ADAMTS13 every 2 weeks. (Funded by the Swiss National Science Foundation.) Recombinant ADAMTS13 in a Pregnant Woman with TTPHereditary thrombotic thrombocytopenic purpura was diagnosed in a pregnant woman at 30 weeks' gestation. Her condition did not respond to plasma exchange, but recombinant ADAMTS13 normalized her platelet count.

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