Influenza A Infection Triggers Thrombotic Thrombocytopenic Purpura by Producing the Anti-ADAMTS13 IgG Inhibitor

• Kosugi Nobuharu

  Department of Internal Medicine, Numazu City Hospital

• Tsurutani Yuya

  Department of Internal Medicine, Numazu City Hospital

• Isonishi Ayami

  Department of Blood Transfusion Medicine, Nara Medical University

• Hori Yuji

  Department of Blood Transfusion Medicine, Nara Medical University

• Matsumoto Masanori

  Department of Blood Transfusion Medicine, Nara Medical University

• Fujimura Yoshihiro

  Department of Blood Transfusion Medicine, Nara Medical University

Abstract

A 68-year-old Japanese woman infected with influenza A developed thrombotic thrombocytopenic purpura (TTP) 2 days after having a fever. Routine laboratory tests on admission suggested a diagnosis of disseminated intravascular coagulation. However, ADAMTS13 assays showed an extremely low level of plasma ADAMTS13 activity with a high titer of anti-ADAMTS13 inhibitor (IgG). Despite high-dose methylprednisolone therapy with daily plasma exchange for 3 consecutive days, the patient died of pulmonary congestion complicated by cardiac failure. Our experience here provides the first evidence that influenza A infection is sufficient to trigger TTP by producing the anti-ADAMTS13 IgG inhibitor.<br>

Journal

• Internal Medicine

  Internal Medicine 49 (7), 689-693, 2010

  The Japanese Society of Internal Medicine

Keywords

• influenza
• TTP

Details

• CRID: 1390001204873493248
• NII Article ID: 130000251788
• DOI: 10.2169/internalmedicine.49.2957
• ISSN: 13497235
• ISSN: 09182918
• Web Site: http://www.jstage.jst.go.jp/article/internalmedicine/49/7/49_7_689/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2010265567
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed