Successful prevention of exacerbation of thrombocytopenia in a pregnant patient with idiopathic thrombocytopenic purpura by anticoagulation treatment

BMC Pregnancy and Childbirth

Koushi Yamaguchi²  Haruhiko Sago²  Nobuhiro Tsukada¹  Michi Hisano² 

[1] Division of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku 150-8935, Tokyo, Japan;Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku 157-8535, Tokyo, Japan

关键词: Anticoagulation;    Thrombocytopenia;    Pregnancy;    Idiopathic thrombocytopenic purpura;   

Others  :  1131191
DOI  :  10.1186/s12884-015-0482-7

 received in 2014-06-04, accepted in 2015-02-19,  发布年份 2015

【 摘 要 】

Background

Corticosteroid or intravenous immunoglobulin is used in the management of idiopathic thrombocytopenic purpura during pregnancy.

Case presentation

A patient with idiopathic thrombocytopenic purpura had a previous history of interrupted pregnancy due to severe thrombocytopenia, and was unresponsive to high doses of corticosteroids and intravenous immunoglobulin. Immediately following pregnancy, our patient had a marked elevation in plasma levels of fibrinogen degradation products, D-dimer, and platelet factor 4, with a decrease in platelets, suggesting platelet activation and thrombogenesis. Combined treatment with an anticoagulant agent could prevent exacerbation of thrombocytopenia throughout pregnancy. Although the underlying causes leading to the series in her pregnancy course were uncertain, there were notable serological abnormalities, such as weakly positive antinuclear antibody and anti-U1-RNP antibody.

Conclusion

When thrombocytopenia rapidly develops in patients with idiopathic thrombocytopenic purpura immediately following pregnancy, the possibility of a thrombogenic state and differential diagnosis, including antiphospholipid syndrome and collagen vascular disease, should be considered. Treatment with an anticoagulant agent might then be appropriate.

【 授权许可】

   
2015 Hisano et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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