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Hypercoagulable States in Rheumatic Disease

  |  Issue: September 2009  |  

Epidemic HUS TTP is becoming increasingly prevalent in Canada, Dr. Kelton reported, because of the increase in the use of organic foods by the general population. Caused by E. coli H-0157, classic HUS TTP will affect about 2% to 3% of the exposed population and can cause long-lasting renal impairment in children. It is more likely to be fatal in adults. Again, small nonrandomized studies also seem to suggest that plasma exchange works in these patients. Although treatment of thrombotic microangiopathies remains “remarkably arbitrary”—even in late 2008—the treatment works, he observed.

References

  1. Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndrome. N Engl J Med. 2007;357:2001-2015.
  2. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):381S-453S.
  3. Rubinstein MA, Kagan BM, Macgillviray MH, Merliss R, Sacks H. Unusual remission in a case of thrombotic thrombocytopenic purpura syndrome following fresh blood exchange transfusions. Ann Intern Med. 1959;51:1409-1419.
  4. Rock GA, Shumak KH, Buskard NA, et al. Comparison of plasma exchange with plasma infusion in the treatment of thrombotic thrombocytopenia purpura. Canadian Apheresis Study Group. N Engl J Med. 1991;325:393-397.

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