Syndrome De Moschowitz Et Grossesse A Propos Daun Cas Avec Revue De La Litterature
Keywords:
Thrombotic thrombocytopenic purpura; pregnancy; treatment; prognosis
Abstract
Thrombotic thrombocytopenic purpura (TTP) is a form of thrombotic microangiopathy (TMA) particularly serious because it can be accompanied by a multi-organ failure. Postmortem studies in these patients revealed the presence of thrombi in the microcirculation of most organs, suggesting that the TTP is a multi-systemic disease.We distinguish sporadic PTT, which permanently cures the PTT recurrent, on the contrary characterized by regular and frequent relapses and intermittent PTT, where relapses occur with irregular frequency.Different types of MAT may encounter during pregnancy and postpartum, as PTT, HUS and HELLP syndrome.The latter is a more specific form of MAT of pregnancy and postpartum, it is sometimes difficult to distinguish TTP and HUS.. This distinction can be based on hepatic dysfunction and disseminated intravascular coagulation, present in the HELLP syndrome and absent in TTP and HUS. Some HUS occurring during postpartum may be related to a heterozygous mutation in the Factor H gene (E. Rondeau, personal communication).Treatment of TTP in pregnancy is also based on the achievement of plasma exchange. Pregnancy does not affect the response to treatment of TTP. However, the effects of plasma exchange on the fetus have not been evaluated. Moreover, in these patients there is a risk of relapse of TTP without any pregnancy. HELLP syndrome is important to distinguish because most often requires a fetal extraction. The specificity of the care of these patients and the risk of recurrence in subsequent pregnancies should motivate monitoring of these patients by centers with experience in this kind of pathology. The treatment of this microangiopathy is called it to resuscitation and plasma exchange. We report a case of a case of thrombocytopenic purpurathrombocytopenic misdiagnosed at first, occurring in a parturient with 36SA given birth vaginally a healthy baby, the evolution was favorable to the patient due to start after plasma exchange non-response to cortic
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2014-05-15
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