Outcome of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome in Japan

Citation
Y. Mori et al., Outcome of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome in Japan, CL APPL T-H, 5(2), 1999, pp. 110-112
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
ISSN journal
1076-0296 → ACNP
Volume
5
Issue
2
Year of publication
1999
Pages
110 - 112
Database
ISI
SICI code
1076-0296(199904)5:2<110:OOTTPA>2.0.ZU;2-7
Abstract
We examined 159 patients with thrombotic thrombocytopenic purpura and hemol ytic uremic syndrome in Japan. The subjects were divided in three groups; 9 0 patients with thrombotic thrombocytopenic purpura, 51 patients with verot oxin-induced hemolytic uremic syndrome, and 18 patients with drug-induced h emolytic uremic syndrome. Eighty-two percent of the patients with thromboti c thrombocytopenic purpura had associated neurological disorders and 78% of drug-induced hemolytic uremic syndrome associated with pulmonary edema. Re nal insufficiency was noted in the 69% cases with both hemolytic uremic syn drome groups. Seventeen patients with thrombotic thrombocytopenic purpura h ad systemic lupus erythematosus and 6 were pregnant. Autoantibody were posi tive in 53% of thrombotic thrombocytopenic purpura. Seventy-seven percent o f patients with thrombotic thrombocytopenic purpura received plasma exchang e at 4,000 mL/day three times a week, 71% antithrombotic agents, and 78% st eroid administration, respectively. However, 27% of the patients with hemol ytic uremic syndrome were treated by hemodialysis in addition to antithromb otic agents. When drug-induced hemolytic uremic syndrome was diagnosed, the drug was immediately discontinued and the patients were treated with antip latelet agents. Seventy-four percent of the patients with thrombotic thromb ocytopenic purpura were alive at 26 weeks compared with 95% of those with h emolytic uremic syndrome. As thrombotic thrombocytopenic purpura had a high mortality rate in Japan, we should carry out early diagnosis and early tre atment.