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Autoimmune hemolytic anemia presenting concurrently with thrombotic thrombocytopenic purpura
Munaf AL-Kadhimi1, Fernanda Wah2, Tamarah AL-Dawoodi1, Julio Peguero1, Luis T Campos1
1MD, Oncology Consultants, Research Department, International Cancer Center, Houston, TX.
2MD, Universidad Autonoma de Tampico, SN Matamoros, Zona Centro Ciudad Victoria, Tamaulipas, CP.

Article ID: 100028CRINTMA2016
doi:10.5348/crint-2016-27-CR-9

Address correspondence to:
Dr. Julio Peguero
MD, 2130 West Holcombe Blvd. 10th Floor
Houston, Texas 77030

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How to cite this article:
AL-Kadhimi M, Wah F, AL-Dawoodi T, Peguero J, Campos LT. Autoimmune hemolytic anemia presenting concurrently with thrombotic thrombocytopenic purpura. Case Rep Int 2016;5:36–39.


Abstract
Thrombotic thrombocytopenic purpura (TTP) is an acute, life-threatening syndrome typically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Both genetic and idiopathic TTP are caused by deficient activity of the serine protease ADAMTS-13, allowing its normal substrate, von Willebrand factor, to polymerize and bind platelets under high sheer conditions. Autoimmune TTP is typically treated by plasmapheresis and corticosteroids. Here, we describe a 69-year-old patient presenting with thrombopenia comorbid with "warm" autoimmune hemolytic anemia (WAIHA). Treatment with steroids and plasma exchange initiated at the beginning and patient acquired a clinical as well as biological response. Thrombotic thrombocytopenic purpura (TTP) is a life-threatening condition typically (but not always) associated with autoimmune or genetic inactivation of the protease ADAMTS-13, for which consistently effective therapeutic interventions remain elusive.

Keywords: Microangiopathic hemolytic anemia (MAHA), Thrombocytopenia, Thrombosis and hemolysis, Thrombotic thrombocytopenic purpura (TTP)


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Author Contributions
Munaf AL-Kadhimi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Fernanda Wah – Substantial contribution to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Tamarah AL-Dawoodi – Substantial contribution to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Julio Peguero – Substantial contribution to conception and design, Analysis and interpretation of data, Final approval of the version to be published
Luis T Campos – Substantial contribution to conception and design, Analysis and interpretation of data, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Dr. Peguero serves in the speaker bureau for Foundation Medicine, Bristol Myers Squibb, and Bayer. He directs phase 1 and 2 clinical trials, funded by various pharmaceutical companies, within the Oncology Consultants Research Department. None of the remaining authors have any conflict of interest.
Copyright
© 2016 Munaf AL-Kadhimi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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