Acute thrombotic thrombocytopenic purpura following orthopedic surgery: a case report

Archives of Orthopaedic and Trauma Surgery
Michael I IosifidisGeorgios Giantsis

Abstract

Thrombotic thrombocytopenic purpura (TTP) or Moschowitz's syndrome is characterized by release of unusually large von Willebrand factor (ULvWF) multimers and a deficiency of vWF metalloprotease. It is a very rare condition, but it causes serious problems. The etiology is still unknown, although surgical stress has been associated with TTP, probably by releasing massive amounts of ULvWF. TTP is an acute, recurrent disease of the circulatory system, consisting of thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological signs, and renal dysfunction. It has the strong possibility of being fatal and thus should be treated immediately, mostly by plasmapheresis. We report a case of TTP following a high tibial valgus osteotomy. An association between TTP and orthopedic surgery--as far as we know--has only once been reported in the literature. We suggest that orthopedic surgeons should be aware of this because, although very rare, postsurgical TTP could be a life-threatening postoperative complication, which needs prompt diagnosis and treatment.

References

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Citations

Jan 1, 2012·Journal of Community Hospital Internal Medicine Perspectives·Naba R MainaliRichard Alweis
Jan 1, 2014·Surgery Today·Ahmet Emre EskazanTeoman Soysal
Aug 10, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Maria Lucia BindiGianni Biancofiore
Oct 29, 2015·The American Journal of Emergency Medicine·Kyoung Hoon Lim, Jinyoung Park
Jun 9, 2016·Der Urologe. Ausg. A·F SchottS Segerer
Jun 30, 2019·European Journal of Haematology·Meera SridharanUNKNOWN Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy Disease-Oriented Group

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