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[Thrombotic thrombocytopenic purpura (TTP) with a low level of apolipoprotein A-I (Apo A-I) which responded to combination of vincristine and beraprost].

Authors
  • Kurosawa, S
  • Nagata, M
  • Saito, T
  • Arai, T
  • Momose, T
  • Morio, K
  • Mitsuhashi, H
Type
Published Article
Journal
[Rinshō ketsueki] The Japanese journal of clinical hematology
Publication Date
Jul 01, 1994
Volume
35
Issue
7
Pages
704–709
Identifiers
PMID: 8065025
Source
Medline
License
Unknown

Abstract

A 51-year-old man was admitted to the psychiatric ward because of increasing confusion and irrational behavior. He was later transferred to our department due to anemia and thrombocytopenia. A diagnosis of thrombotic thrombocytopenic purpura (TTP) was made based on the presence of thrombocytopenic purpura, microangiopathic hemolytic anemia, neurological symptoms and fever. Corticosteroids, plasma exchange (PE), dextrans, dipyridamole and vincristine (VCR) were given without satisfactory response. Beraprost sodium was prescribed followed by a dramatic improvement and complete remission. A number of reports indicated that prostacyclin metabolism was involved in the pathogenesis of TTP. Recently Apo A-I was identified to be a prostacyclin-stabilizing factor, which was initially low in this patient. If patients do not respond to either PE or VCR, consideration should be given to treatment with beraprost, especially when the level of Apo A-I is low.

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