Treatment of Concurrent Thrombotic Thrombocytopenic Purpura and Graves' Disease: A Report on Two Cases

Case Reports in Endocrinology
Karl LhottaAlexander Becherer

Abstract

Graves' disease (GD) and thrombotic thrombocytopenic purpura (TTP) are autoimmune diseases caused by autoantibodies against the TSH receptor (TRAb) and the enzyme ADAMTS13. We here report on two patients with concurrent GD and TTP, who achieved sustained remission of both conditions with the TTP treatment regimen and thiamazole. Both patients suffered from relapsing TTP and were diagnosed with GD concomitantly at the time of relapse. They were treated with steroids, plasma exchange, rituximab, and thiamazole. This therapy induced complete remission of TTP. TRAb levels also decreased rapidly and both patients developed subclinical hypothyroidism three and five weeks later. Our observations suggest that TTP and GD may be concomitant and that GD possibly triggers a relapse of TTP. The combination of thyrostatic treatment and immunosuppression with PE, rituximab, and steroids is able to induce rapid and prolonged remission of GD.

References

Jul 1, 1989·Seminars in Nuclear Medicine·L S ZuckierM D Scharff
Feb 8, 2007·The Journal of Clinical Endocrinology and Metabolism·Daniel El FassiLaszlo Hegedüs
Aug 19, 2007·The American Journal of the Medical Sciences·Bassem T ChaarBrenda J Grossman
Jul 17, 2008·European Journal of Endocrinology·Karen A HeemstraJohannes W Smit
Oct 31, 2008·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Daniel El FassiClaus H Nielsen
Jan 28, 2010·The American Journal of Medicine·Kristien BoelaertJayne A Franklyn
May 31, 2012·Journal of Clinical Apheresis·Saurabh Chhabra, Grace Tenorio
Mar 29, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Flavio BellanteSophie Dethy
Oct 25, 2014·The Journal of Clinical Endocrinology and Metabolism·Marius N StanRebecca S Bahn
Dec 17, 2014·The Journal of Clinical Endocrinology and Metabolism·Mario SalviPaolo Beck-Peccoz
Jan 17, 2015·The Lancet. Diabetes & Endocrinology·Michael B Zimmermann, Kristien Boelaert
Dec 17, 2015·JAMA : the Journal of the American Medical Association·Henry B Burch, David S Cooper
Nov 1, 2016·The New England Journal of Medicine·Terry J Smith, Laszlo Hegedüs

❮ Previous
Next ❯

Citations

Apr 22, 2020·Proceedings·Junlin ZhangWilliam C Roberts
Dec 14, 2019·Journal of Medical Case Reports·Saira ChaughtaiMohammad A Hossain
Jun 14, 2021·Korean Journal of Ophthalmology : KJO·Volkan YeterElif Kiliç Kan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

Related Papers

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Jérôme HarambatOlivier Brissaud
[Rinshō ketsueki] The Japanese journal of clinical hematology
H Fujii, T Maekawa
© 2022 Meta ULC. All rights reserved