Which medications can cause TTP?
The clinical features of TTP-HUS associated with these drugs are different, suggesting two principal mechanisms by which drugs may cause TTP-HUS: dose-related toxicity (mitomycin C, cyclosporine), and immune-mediated reaction (quinine, ticlopidine, clopidogrel).
What is drug-induced thrombotic microangiopathy?
Introduction. Drug-induced thrombotic microangiopathy (DITMA) is a life-threatening complication that is often under-recognized and under-reported (1). Despite recent systematic reviews published in 2015 (2) and 2018 (3), the list of drugs implicated in TMA continues to expand (4–9).
How is TMA treated?
For example, infectious causes of TMA might be treated with antibiotics and supportive care. At times, plasma exchange, immune suppression, and/or complement blocking therapies may be used to treat other causes of TMA. Individuals with severe kidney injury may require dialysis.
What causes thrombotic microangiopathy?
The specific cause is dependent of the type of TMA that is presented, but the two main pathways that lead to TMA are external triggers of vascular injury, such as viruses, bacterial Shiga toxins or endotoxins, antibodies, and drugs; and congenital predisposing conditions, including decreased levels of tissue factors …
Can NSAIDs cause thrombocytopenia?
Other medicines that cause drug-induced thrombocytopenia include: Furosemide. Gold, used to treat arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs)
Which is the treatment of choice for thrombotic thrombocytopenic purpura TTP?
The therapy of choice is plasma exchange with fresh frozen plasma and immunosuppression. In January 2019 the FDA approved caplacizumab (Cablivi) for adults with acquired thrombotic thrombocytopenic purpura (aTTP), in combination with plasma exchange and immunosuppressive therapy.
What causes Maha?
Possible causes of MAHA include mechanical heart valve, malignant hypertension, vasculitis, adenocarcinoma, preeclampsia/eclampsia, disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), and hemolytic-uremic syndrome (HUS)/atypical HUS (see Chapter 20, Disorders of Hemostasis and …
Is TMA curable?
TTP was once fatal in 90% of individuals who developed the disease. Now that plasma exchange is available, survival can be as high as 80%. In many cases the blood vessel damage in the kidneys and brain will reverse with time. HUS has a good prognosis.
How is thrombotic microangiopathy diagnosed?
How is the diagnosis of thrombotic microangiopathy made? Thrombotic microangiopathy is a clinicopathologic diagnosis. The constellation of thrombocytopenia, anemia and red blood cell fragmentation (i.e., schistocytes) on the blood film is sufficient to make the diagnosis (Figure 1).
Which antibiotics can cause thrombocytopenia?
Medicines Known to Cause DITP
| Medicine Classification | Examples of Implicated Medicines |
|---|---|
| Antibiotics | Cephalosporins, linezolid, penicillins, sulphonamides, trimethoprim, vancomycin |
| Antimalarials | Quinine |
| Antimycobacterials | Ethambutol, rifampicin |
| Antiepileptics | Carbamazepine, phenytoin, sodium valproate |
What medicines affect platelet count?
List of Drugs that may cause Decrease In Platelet (Thrombocytopenia)
- Acetaminophen and Codeine.
- Ado-trastuzumab Emtansine.
- Bosutinib.
- Nadroparin.
- Oxaliplatin.
- Pralatrexate Solution.
- Sirolimus.
- Sulfasalazine.
How does rituximab work for TTP?
Rituximab (licensed and internationally used monoclonal antibody) selectively acts on white blood cells known as B-lymphocytes or B cells that produce the antibody to ADAMTS 13. By inhibiting ADAMTS 13 antibody production, ADAMTS 13 activity increases, resulting in remission.
What is thrombotic microangiopathy?
Thrombotic Microangiopathy. What is it? Thrombotic microangiopathies (TMA) are clinical syndromes defined by the presence of hemolytic anemia (destruction of red blood cells), low platelets, and organ damage due to the formation of microscopic blood clots in capillaries and small arteries.
What is drug-induced thrombotic microangiopathy (ditma)?
Drug-induced thrombotic microangiopathy (DITMA) is a life-threatening complication that is often under-recognized and under-reported (1). Despite recent systematic reviews published in 2015 (2) and 2018 (3), the list of drugs implicated in TMA continues to expand (4–9).
Is there an association between antiretroviral therapy and drug-induced immune thrombocytopenia purpura?
A novel association between antiretroviral therapy and drug-induced immune thrombocytopenia purpura. Acta Haematol. (2019) 141:199–200. 10.1159/000496325 [PubMed] [CrossRef] [Google Scholar]
What is TMA (thrombotic thrombocytopenic purpura)?
Historically, TMA were often referred to as TTP/HUS, or thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. It is now recognized that a large number of different diseases can result in TMA.