Abstract
A 68-year-old Japanese woman infected with influenza A developed thrombotic thrombocytopenic purpura (TTP) 2 days after having a fever. Routine laboratory tests on admission suggested a diagnosis of disseminated intravascular coagulation. However, ADAMTS13 assays showed an extremely low level of plasma ADAMTS13 activity with a high titer of anti-ADAMTS13 inhibitor (IgG). Despite high-dose methylprednisolone therapy with daily plasma exchange for 3 consecutive days, the patient died of pulmonary congestion complicated by cardiac failure. Our experience here provides the first evidence that influenza A infection is sufficient to trigger TTP by producing the anti-ADAMTS13 IgG inhibitor.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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ADAM Proteins / antagonists & inhibitors*
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ADAM Proteins / blood
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ADAM Proteins / immunology
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ADAMTS13 Protein
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Aged
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Antibodies, Anti-Idiotypic* / blood
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Antibodies, Anti-Idiotypic* / immunology
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Female
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Humans
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Immunoglobulin G / blood
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Immunoglobulin G / immunology
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Influenza A virus*
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Influenza, Human / blood
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Influenza, Human / complications*
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Influenza, Human / immunology
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Purpura, Thrombotic Thrombocytopenic / blood
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Purpura, Thrombotic Thrombocytopenic / etiology*
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Purpura, Thrombotic Thrombocytopenic / immunology
Substances
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Antibodies, Anti-Idiotypic
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Immunoglobulin G
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anti-IgG
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ADAM Proteins
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ADAMTS13 Protein
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ADAMTS13 protein, human