Thrombotic thrombocytopenic purpura (TTP), a disease of
unknown cause, has been reported relatively frequently during
pregnancy. The disorder typically runs a fulminant course with a
high mortality, and survival of both mother and fetus has been
exceedingly rare. We report here the fourth case of TTP during
pregnancy in which both the mother and fetus survived. Therapeutic approaches to TTP have included corticosteroids, antiplatelet agents, splenectomy, and, more recently, exchange
plasmapheresis, exchange transfusion, and plasma infusion.
The patient described herein was refractory to corticosteroids,
antiplatelet agents, and only transiently responsive to exchange
transfusion. The administration of plasma infusions achieved a
sustained partial remission that allowed full gestation of the
developing fetus. The patient attained full remission following
cesarean section and simultaneous splenectomy.
(Arch Intern Med 140:981-983, 1980)
Walker BK, Ballas SK, Martinez J. Plasma Infusion for Thrombotic Thrombocytopenic Purpura During Pregnancy. Arch Intern Med. 1980;140(7):981–983. doi:10.1001/archinte.1980.00040020981024