TTP and AIDS

PubMed, the internet portal of biomedical and life sciences literature, indexed a report on “Thrombotic thrombocytopenic purpura in a patient with acquired immunodeficiency syndrome at 28 weeks gestation“ (Am J Perinatol. 2005 May;22(4):223-5). Authors are Sherer DM, Sanmugarajah J, Dalloul M et al. from the Divisions of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Obstetrics and Gynecology, State University of New York, USA. An increased incidence of thrombotic thrombocytopenic purpura (TTP) has been reported among human immunodeficiency virus-infected patients or those with acquired immunodeficiency syndrome (AIDS). Despite this association, hitherto only a single case of TTP has been reported in an HIV-infected patient during pregnancy. The authors describe a young multiparous patient with long-standing AIDS who presented with lower abdominal pain. Following findings of thrombocytopenia, microangiopathic hemolytic anemia, renal failure, low-grade fever, and mental status changes, thrombotic thrombocytopenic purpura was diagnosed after initially considering the diagnosis of severe preeclampsia, and the patient was delivered by cesarean section. The patient required multiple plasma exchanges during a protracted postpartum course, and was discharged in good health. This first report of TTP and AIDS in pregnancy demonstrates that when encountering preeclampsia in patients with AIDS, thrombotic microangiopathy should be strongly considered. To access the full abstract of the report, click here.