A case of Systemic lupus erythematosus secondary to thrombotic thrombocytopenic purpura combined with pregnancy and review of the literature

Corresponding author: YAN Xiao., yanxiao.nb@outlook.com

DOI: 10.12201/bmr.202504.00053

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  Abstract: Thrombotic thrombocytopenic purpura (TTP) is a rare and critical condition, and pregnant patients with secondary systemic lupus erythematosus (SLE) are even rarer. This article reports the clinical management of a patient diagnosed with SLE at 12 weeks gestation with sudden onset of TTP. The patient was admitted to the hospital due to intermittent fever and unconsciousness, and various laboratory tests confirmed the diagnosis of immune TTP, and after emergency plasma exchange combined with glucocorticoids and rituximab, the patient underwent forceps curettage and uterine evacuation under general anesthesia due to confusion and irritability. After treatment, platelets gradually returned to normal, and the ADAMTS13 activity recovered 100%, and the patients were in good survival status after follow-up. This article reviews and summarizes this case, analyzes the relevant characteristics and pathological mechanisms of TTP secondary to SLE pregnancy patients, and broadens the diagnosis and treatment ideas for patients with significant clinical platelet reduction, so as to improve clinicians understanding of the disease and reduce the rate of missed diagnosis and misdiagnosis.

  Key words: thrombotic thrombocytopenic purpura; pregnancy; Systemic lupus erythematosus; plasma exchange

  Submit time: 17 April 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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