Thrombotic thrombocytopenic purpura in 166 pregnancies: 1955-2006

American Journal of Obstetrics and Gynecology

Volumn 199, Issue 2, 2008, Pages 98-104

  Martin Jr , James N ^a   Bailey, Amelia P ^a   Rehberg, Jonathan F ^a   Owens, Michelle T ^a   Keiser, Sharon Dixon ^a   May, Warren L ^b  

^a UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF MISSISSIPPI MEDICAL CENTER   (United States)

Author keywords

and low platelets syndrome; elevated liver enzymes; hemolysis; lactate dehydrogenase to aspartate aminotransferase ratio; preeclampsia; thrombotic thrombocytopenic purpura

Indexed keywords

ASPARTATE AMINOTRANSFERASE; LACTATE DEHYDROGENASE;

AMINOTRANSFERASE BLOOD LEVEL; DELAYED DIAGNOSIS; HELLP SYNDROME; HEMOLYSIS; HUMAN; LABORATORY TEST; LACTATE DEHYDROGENASE BLOOD LEVEL; MATERNAL MORTALITY; PLASMA TRANSFUSION; PREECLAMPSIA; PREGNANCY; PRIORITY JOURNAL; PUERPERIUM; REVIEW; SECOND TRIMESTER PREGNANCY; THROMBOTIC THROMBOCYTOPENIC PURPURA;

ADAM PROTEINS; ASPARTATE AMINOTRANSFERASES; FEMALE; HELLP SYNDROME; HUMANS; L-LACTATE DEHYDROGENASE; MATERNAL MORTALITY; PREGNANCY; PREGNANCY COMPLICATIONS, CARDIOVASCULAR; PURPURA, THROMBOTIC THROMBOCYTOPENIC;

EID: 47949117575     PISSN: 00029378     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ajog.2008.03.011     Document Type: Review

References (114)

1. Terrell D.R., Williams L.A., Vesely S.K., Lammie B., Hovinga J.A., and George J.N. The incidence of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: All patients, idiopathic patients, and patients with severe ADAMTS-13 deficiency. J Thromb Haemost 3 (2005) 1432-1436
2. George J.N. Thrombotic thrombocytopenic purpura. N Engl J Med 354 (2006) 1927-1935
3. Moake J.L. Thrombotic microangiopathies: Mechanisms of disease. N Engl J Med 347 (2002) 589-600
4. Moake J.L. Thrombotic thrombocytopenic purpura: The systemic clumping "plague". Annu Rev Med 53 (2002) 75-88
5. George J.N. ADAMTS13, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. Curr Hem Rep 4 (2005) 167-169
6. Murrin R.J.A., and Murray J.A. Thrombotic thrombocytopenic purpura: aetiology, pathophysiology and treatment. Blood Rev 20 (2006) 51-60
7. Nguyen T.C., Stegmayr B.G., Busund R., Bunchman T.E., and Carcillo J.A. Plasma therapies in thrombotic syndromes. Int J Art Org 28 (2005) 459-465
8. Rehberg J.F., Briery C.M., Hudson W.T., Bofill J.A., and Martin Jr. J.N. Thrombotic thrombocytopenic purpura masquerading as hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome in late pregnancy. Obstet Gynecol 108 (2006) 817-820
9. Sibai B.M. Imitators of severe preeclampsia. Obstet Gynecol 109 (2007) 956-966
10. Martin Jr. J.N., Rose C.H., and Briery C.M. Understanding and managing HELLP syndrome: The integral role of aggressive glucocorticoids for mother and child. Am J Obstet Gynecol 195 (2006) 914-934
11. Miner P.F., Nutt R.L., and Thomas M.E. Thrombotic thrombocytopenic purpura occurring in pregnancy. Am J Obstet Gynecol 70 (1955) 611-617
12. Reisfield D.R. Thrombotic thrombocytopenic purpura and pregnancy. Obstet Gynecol Survey 14 (1959) 303-321
13. O'Leary J.A., and Marchetti A.A. Thrombotic thrombocytopenic purpura in pregnancy. Am J Obstet Gynecol 83 (1962) 214-219
14. Reisfield D.R. Death from thrombotic thrombocytopenic purpura during pregnancy. Obstet Gynecol 19 (1962) 517-520
15. Solomon W., Turner D.S., Block C., and Posner A.C. Thrombotic thrombocytopenic purpura in pregnancy. JAMA 184 (1963) 587-590
16. O'Leary J.A., and Tovell H.M.M. Thrombotic thrombocytopenic purpura complicating pregnancy. Bulletin Sloane Hosp (1963) 6-9
17. Castleman B.J., and McNeely B.U. Case 50-1966-case records of the Massachusetts General Hospital. N Engl J Med 275 (1966) 1125-1133
18. Piver M.S., Lisker S.A., Rowan N., Weber L.L., Brody J.I., and Beizer L.H. Thrombotic thrombocytopenic purpura during pregnancy. Am J Obstet Gynecol 100 (1968) 302-304
19. Hill J.B., and Cooper W.M. Thrombotic thrombocytopenic purpura: treatment with corticosteroids and splenectomy. Arch Intern Med 122 (1968) 353-356
20. Richardson J.H., and Smith B.T. Thrombotic thrombocytopenic purpura: survival in pregnancy with heparin sodium therapy. JAMA 203 (1968) 176-177
21. Tapp E., Geary C.G., and Dawson D.W. Thrombotic micro-angiopathy with macroscopic infarction. J Pathol 97 (1969) 711-716
22. Bernard R.P., Bauman A.W., and Schwartz S.I. Splenectomy for thrombotic thrombocytopenic purpura. Ann Surg 169 (1969) 616-624
23. Scharoff J.R., Serlin N., and Atamer M.A. Thrombotic thrombocytopenic purpura: Report of a case treated with splenectomy and steroids. Acta Haematol 41 (1969) 180-185
24. Edmondson W.P., and Sturgill B.C. Clinicopathological conference: Fever, abdominal pain and eclampsia. Va Med Mon (1918) 97 (1970) 174-185
25. Mant M.J., Cauchi M.N., and Medley G. Thrombotic thrombocytopenic purpura: Report of a case with possible immune etiology. Blood 40 (1972) 416-421
26. Moon E.C., and Kitay D.Z. Hematologic problems of pregnancy: II. Thrombotic (thrombohemolytic) thrombocytopenia purpura. J Reprod Med 9 (1972) 212-221
27. Perel I.D., and Forgan-Smith W.R. Thrombotic thrombocytopenic purpura presenting as eclampsia. Aust N Z J Obstet Gynecol 12 (1972) 257-262
28. Jaffe E.A., Nachman R.L., and Merskey C. Thrombotic thrombocytopenic purpura-coagulation parameters in twelve patients. Blood 42 (1973) 499-507
29. Vandewalle A., Kanfer A., and Kourilsky O. Oliguric thrombotic microangiopathy during the fifth month of pregnancy. Br Med J 2 (1975) 479
30. Barrett C., and Marshall J.R. Thrombotic thrombocytopenic purpura. Obstet Gynecol 46 (1975) 231-235
31. Vilanova J.R., Norenberg M.D., and Stuard I.D. Thrombotic thrombocytopenic purpura: Systemic embolization from nonbacterial thrombotic endocarditis. N Y State J Med 75 (1975) 2246-2248
32. Dalal F.Y., Bennett E.J., Grundy E.M., Younes S., and Orfei E. Anesthetic considerations in diffuse bleeding diathesis of uncertain origin. Anesth Analgesia 55 (1976) 173-176
33. Fuchs W.E., George J.N., Dotin L.N., and Sears D.A. Thrombotic thrombocytopenic purpura: Occurrence two years apart during late pregnancy in two sisters. JAMA 235 (1976) 2126-2127
34. Neame P.B., Hirsh J., Browman G., Denburg J., D'Souza T.J., Gallus A., and Brain M.C. Thrombotic thrombocytopenic purpura: A syndrome of intravascular platelet consumption. CMAJ 114 (1976) 1108-1112
35. May H.V., Harbert G.M., and Thornton W.N. Thrombotic thrombocytopenic purpura associated with pregnancy. Am J Obstet Gynecol 126 (1976) 452-458
36. Fitzgibbons J.F., Goodnight S.H., Burkhardt J.H., and Kirk P.E. Survival following thrombotic thrombocytopenic purpura in pregnancy. Obstet Gynecol 50 (1977) 66s-68s
37. Bukowski R.M., King J.W., and Hewlett J.S. Plasmapheresis in the treatment of thrombotic thrombocytopenic purpura. Blood 50 (1977) 413-417
38. Byrnes J.J., and Khurana M. Treatment of thrombotic thrombocytopenic purpura with plasma. N Engl J Med 297 (1977) 1386-1389
39. Lian E.C.-Y., Harkness D.R., Byrnes J.J., Wallach H., and Nunez R. Presence of a platelet aggregating factor in the plasma of patients with thrombotic thrombocytopenic purpura (TTP) and its inhibition by normal plasma. Blood 53 (1979) 333-338
40. Yang C., Nussbaum M., and Park H. Thrombotic thrombocytopenic purpura in early pregnancy: Remission after plasma exchange. Acta Haematol 62 (1979) 112-116
41. Wurzel J.M. TTP lesions in placenta but not fetus. N Engl J Med 301 (1979) 503-504
42. Bateman S.M., Hilgard P., and Gordon-Smith E.C. Thrombotic thrombocytopenic purpura: A possible plasma factor deficiency. Br Soc Haematol 20 (1979) 498-499
43. Perkins R.P. Thrombocytopenia in obstetric syndromes: a review. Obstet Gynecol Surv 34 (1979) 101-114
44. Benson D.O., Fitzgibbons J.F., and Goodnight S.H. The visual system in thrombotic thrombocytopenic purpura. Ann Ophthalmol 12 (1980) 413-417
45. Walker B.K., Ballas S.K., and Martinez J. Plasma infusion for thrombotic thrombocytopenic purpura during pregnancy. Arch Intern Med 140 (1980) 981-983
46. Cuttner J. Thrombotic thrombocytopenic purpura: A ten-year experience. Blood 56 (1980) 302-306
47. Rossi E.C., del Greco F., Kwaan H.C., and Lerman B.B. Hemodialysis-exchange transfusion for treatment of thrombotic thrombocytopenic purpura. JAMA 244 (1980) 1466-1468
48. Shinoda A., Kitada H., Suzuki S., et al. Accessible plasma exchange using membrane filters-a successfully treated case of TTP with repeated plasma exchanges. Artif Organs 5 (1981) 248-253
49. Atlas M., Barkai G., Menczer J., Houlu N., and Lieberman P. Thrombotic thrombocytopenic purpura in pregnancy. Br J Obstet Gynaecol 89 (1982) 476-479
50. Kitchens C.S. Studies of a patient with recurring thrombotic thrombocytopenic purpura. Am J Hematol 13 (1982) 259-267
51. Holdrinet R.S.G., DePauw B.E., and Haanen C. Hormonal dependent thrombotic thrombocytopenic purpura (TTP). Scand J Haematol 30 (1983) 250-256
52. Blakowski S.A., Zacharski L.R., and Telfer M.C. Pregnancy complicated by thrombotic thrombocytopenic purpura with fetal sparing. Arch Intern Med 143 (1983) 2207-2208
53. Caggiano V., Fernando L.P., Schneider J.M., Haesslein H.C., and Watson-Williams E.J. Thrombotic thrombocytopenic purpura: Report of fourteen cases-occurrence during pregnancy and response to plasma exchange. J Clin Apheresis 1 (1983) 71-85
54. Lian E.C.-Y., Byrnes J.J., and Harkness D.R. Two successful pregnancies in a woman with chronic thrombotic thrombocytopenic purpura treated by plasma infusion. Am J Hematol 16 (1984) 287-291
55. Vandekerckhove F., Noens L., Colardyn F., Thiery M., and Delbarge W. Thrombotic thrombocytopenic purpura mimicking toxemia of pregnancy. Am J Obstet Gynecol 150 (1984) 320-322
56. Davies G.E. Thrombotic thrombocytopenic purpura in pregnancy with maternal survival: Case report. Br J Obstet Gynecol 91 (1984) 396-398
57. Ambrose A., Welham R.T., and Cefalo R.C. Thrombotic thrombocytopenic purpura in early pregnancy. Obstet Gynecol 66 (1985) 267-272
58. Natelson E.A., and White D. Recurrent thrombotic thrombocytopenic purpura in early pregnancy: effect of uterine evacuation. Obstet Gynecol 66 (1985) 54S-56S
59. Blitzer J.B., Granfortuna J.M., Gottlieb A.J., et al. Am J Hematol 24 (1987) 329-339
60. Koyama T., Oura Y., Kakishita E., et al. A case report: Successful delivery in a female with thrombotic thrombocytopenic purpura. Japan J Med 26 (1987) 381-384
61. Pinette M.G., Vintzileos A.M., and Ingardia C.J. Thrombotic thrombocytopenic purpura as a cause of thrombocytopenia in pregnancy: Literature review. Am J Perinatol 6 (1989) 55-57
62. Ezra Y., Mordel N., Sadovsky E., Schenker J.G., and Eldor A. Successful pregnancies of two patients with relapsing thrombotic thrombocytopenic purpura. Int J Gynecol Obstet 29 (1989) 359-363
63. Koyama T., Suehiro A., Kakishita E., et al. Efficacy of high molecular weight fraction of plasma for the maintenance of pregnancy associated with thrombotic thrombocytopenic purpura. Am J Hematol 35 (1990) 179-183
64. Maina A., Donvito V., Giachino O., Stratta P., and Camaschella C. Thrombotic thrombocytopenic purpura in pregnancy with maternal and fetal survival: Case report. Br J Obstet Gynaecol 97 (1990) 443-445
65. Roberts A.W., Gillett E.A., and Fleming S.J. Hemolytic uremic syndrome/thrombotic thrombocytopenic purpura: Outcome with plasma exchange. J Clin Apheresis 6 (1991) 150-154
66. Thorp Jr. J.M., Wells S.R., and Bowes Jr. W.A. The obfuscation continues: Severe preeclampsia versus thrombotic thrombocytopenic purpura. N C Med J 52 (1991) 126-128
67. Khoo U.S., Dickens P., and Cheung A.N.Y. Rapid death from thrombotic thrombocytopenic purpura following cesarean section. Forensic Sci Int 54 (1992) 75-80
68. Permezel M., Lee N., and Corry J. Thrombotic thrombocytopenic purpura in pregnancy. Aust N Z J Obstet Gynaecol 32 (1992) 278-280
69. Wiznitzer A., Mazor M., Leiberman J.R., Var-Levie Y., Gurman G., and Glezerman M. Familial occurrence of thrombotic thrombocytopenic purpura in two sisters during pregnancy. Am J Obstet Gynecol 166 (1992) 20-21
70. Uslu M., Guzelmeric K., and Asut I. Familial thrombotic thrombocytopenic purpura imitating HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) in two sisters during pregnancy. Am J Obstet Gynecol (1994) 699-700
71. Alqadah F., Zebeib M.A., and Awidi A.S. Thrombotic thrombocytopenic purpura associated with pregnancy in two sisters. Postgrad Med J 69 (1993) 229-231
72. Rozdzinski E., Hertenstein B., Schmeiser T., Seifried E., Kurrle E., and Heimpel H. Thrombotic thrombocytopenic purpura in early pregnancy with maternal and fetal survival: Case report. Ann Hematol 64 (1992) 245-248
73. Vianelli N., Gugliotta, Catani L., Baravelli S., and Tura S. Thrombotic thrombocytopenic purpura: relapse and pregnancy. Haematologica 78 (1993) 259
74. Helou J., Nakhle S., Shoenfeld S., Nasseir T., and Shalev E. Postpartum thrombotic thrombocytopenic purpura: Report of a case and review of the literature. Obstet Gynecol Surv 49 (1994) 785-789
75. Olenich M., and Schattner E. Postpartum thrombotic thrombocytopenic purpura (TTP) complicating pregnancy-associated immune thrombocytopenic purpura (ITP). Ann Intern Med 120 (1994) 845-847
76. Hayward C.P.M., Sutton D.M.C., Carter Jr. W.H., et al. Treatment outcomes in patients with adult thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Arch Intern Med 154 (1994) 982-987
77. Mokrzycki M.H., Rickles R.F., Kaplan A.A., and Kohn O.F. Thrombotic thrombocytopenic purpura in pregnancy: Successful treatment with plasma exchange. Blood Purif 13 (1995) 271-282
78. Puza S., and Malee M.P. Chronic relapsing thrombotic thrombocytopenic purpura in pregnancy: A case report. J Matern Fetal Med 5 (1996) 328-332
79. Egerman R.S., Witlin A.G., Friedman S.A., and Sibai B.M. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome in pregnancy: Review of 11 cases. Am J Obstet Gynecol 175 (1996) 950-956
80. Ezra Y., Rose M., and Eldor A. Therapy and prevention of thrombotic thrombocytopenic purpura during pregnancy: A clinical study of 16 pregnancies. Am J Hematol 51 (1996) 1-6
81. Rund D., Schaap T., and Gillis S. Intensive plasmapheresis for severe thrombotic thrombocytopenic purpura: long-term clinical outcome. J Clin Apheresis 12 (1997) 194-195
82. Furlan M., Robles R., Solenthaler M., Wassmer M., Sandoz P., and Lammie B. Deficient activity of von Willebrand Factor-cleaving protease in chronic relapsing thrombotic thrombocytopenic purpura. Blood 89 (1997) 3097-3103
83. Dashe J.S., Ramin S.M., and Cunningham F.G. The long-term consequences of thrombotic microangiopathy (thrombotic thrombocytopenic purpura and hemolytic uremic syndrome) in pregnancy. Obstet Gynecol 91 (1998) 662-668
84. Kemp W.L., Barnard J.J., and Prahlow J.A. Death due to thrombotic thrombocytopenic purpura in pregnancy. Am J Forensic Med Pathol 20 (1999) 189-198
85. Brostrom S., and Bergmann O.J. Thrombotic thrombocytopenic purpura: A difficult differential diagnosis in pregnancy. Acta Obstet Gynecol Scand 79 (2000) 84-85
86. Mastrobattista J.M., Ramin S.M., and Gilstrap III L.C. Thrombotic thrombocytopenic purpura in pregnancy. Prim Care Update Ob Gyns 7 (2000) 168-171
87. Cao L., Morrow M., lally T., Lin E., and deChristopher P.J. Surge of anti-SSA antibody associated with fulminant thrombotic thrombocytopenic purpura in pregnancy. South Med J 94 (2001) 1219-1222
88. Ranzini A.C., Chavez M.R., Ghigliotty B., and Porcelli M. Thrombotic thrombocytopenic purpura and human immunodeficiency virus complicating pregnancy. Obstet Gynecol 100 (2002) 1133-1136
89. Proia A., Paesano R., Torcia F., et al. Thrombotic thrombocytopenic purpura and pregnancy: A case report and a review of the literature. Ann Hematol 81 (2002) 210-214
90. Cosmai E.M., Puzis L., Tsai H.-M., and Lian E.C.-Y. Thrombotic thrombocytopenic purpura and cardiomyopathy in pregnancy reversed by combined plasma exchange and infusion. Eur J Haematol 68 (2002) 239-242
91. Obeidat B., MacDougall J., and Harding K. Plasma exchange in a woman with thrombotic thrombocytopenic purpura or severe preeclampsia. Br J Obstet Gynaecol 109 (2002) 961-962
92. Sivakumaran M., and Roland J. Prophylactic treatment with fresh frozen plasma in chronic thrombotic thrombocytopenic purpura. Br J Haemat 117 (2002) 480-483
93. Richmond J.R., Koufogianis V., Benjamin A., and Warner M.N. A case of thrombotic thrombocytopenic purpura and neonatal alloimmune thrombocytopenia in the same pregnancy. Br J Obstet Gynaecol 110 (2003) 533-536
94. Ducloy-Bouthors A.-S., Caron C., Subtil D., et al. Thrombotic thrombocytopenic purpura: Medical and biological monitoring of six pregnancies. Eur J Obstet Gynecol Reprod Biol 111 (2003) 146-152
95. Patnaik M.M., Deshpande A.K., Nagar V.S., and Algotar K.M. Thrombotic microangiopathies presenting as an obstetric emergency. J Assoc Physicians India 52 (2004) 152-153
96. Shamseddine A., Chehal A., Usta I., Salem Z., El-Saghir N., and Taher A. Thrombotic thrombocytopenic purpura and pregnancy: Report of four cases and literature review. J Clin Apheresis 19 (2004) 5-10
97. Soltes L., Schmalfuss I.M., and Bhatti M.T. Cortical blindness due to reversible posterior leukoencephalopathy syndrome in a patient with thrombotic thrombocytopenic purpura and preeclampsia. Arch Opthal 122 (2004) 1885-1887
98. Sherer D.M., Sanmugarajah J., Dalloul M., Temkin S.M., Thanus J., and Abulafia O. Thrombotic thrombocytopenic purpura in a patient with acquired immunodeficiency syndrome at 28 weeks gestation. Am J Perinatol 22 (2005) 223-225
99. Vesely S.K., Li X., McMinn J.R., Terrell D.R., and George J.N. Pregnancy outcomes after recovery from thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Transfusion 44 (2004) 1149-1158
100. Castella M., Pujol M., Julia A., et al. Thrombotic thrombocytopenic purpura and pregnancy: A review of ten cases. Vox Sang 87 (2004) 287-290
101. Scully M., Starke R., Lee R., et al. Successful management of pregnancy in women with a history of thrombotic thrombocytopenic purpura. Blood Coagul Fibrinolysis 17 (2006) 459-463
102. Moake J.L. Thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. Arch Pathol Lab Med 126 (2002) 1430-1433
103. Simas T.A.M., Crawford S.L., Solitro M.J., Frost S.C., Meyer B.A., and Maynard S.E. Angiogenic factors for the prediction of preeclampsia in high risk women. Am J Obstet Gynecol 197 (2007) 244-247
104. Salahuddin S., Lee Y., Vadnais M., Sachs B.P., Karumanchi A., and Lim K.-H. Diagnostic utility of soluble fms-like tyrosine kinase 1 and soluble endoglin in hypertensive diseases of pregnancy. Am J Obstet Gynecol 197 (2007) 28-29
105. Staff A.C., Braekke K., Johnsen G.M., Karumachi A., and Harsem N.K. Circulating concentrations of soluble endoglin (CD105) in fetal and maternal serum and in amniotic fluid in preeclampsia. Am J Obstet Gynecol 197 (2007) 176-178
106. Robinson C.J., and Johnson D.D. Soluble endoglin as a second trimester marker for preeclampsia. Am J Obstet Gynecol 197 (2007) 174-176
107. Allford S.L., Hunt B.J., Rose P., and Machin S.J. Guideline: Guidelines on the diagnosis and management of the thrombotic microangiopathic haemolytic anaemias. Br J Hematol 120 (2003) 556-573
108. Barbot J., Costa E., Guerra M., Barreirinho M.S., Isvarlal P., and Robles R. Ten years of prophylactic treatment with fresh frozen plasma in a child with chronic relapsing TTP as a result of a congenital deficiency of von Willebrand factor cleaving protease. Br J Haematol 113 (2001) 649-651
109. McCarthy L.J., Dlott J.S., Orzi A., Waxman D., Miraglia C.C., and Danielson C.F.M. Thrombotic thrombocytopenic purpura: Yesterday, today, tomorrow. Ther Apher Dial 8 (2004) 80-86
110. Sullivan C.A., and Martin Jr. J.N. Thrombotic microangiopathies. In: Didly III G.A. (Ed). Critical care obstetrics. 4th ed. (2004), Blackwell Publishing, Maiden (MA) 408-419
111. Lattuada A., Rossi E., Calzarossa C., Candolfi R., and Mannucci P.M. Mild to moderate reduction of von Willebrand factor cleaving protease (ADAMTS-13) in pregnant women with HELLP microangiopathic syndrome. Haematologica 88 (2003) 1029-1034
112. Hulstein J.J.J., Van Runnard Heimel P.J., Franx A., et al. Acute activation of the endothelium results in increased levels of active von Willebrand factor in hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. J Thromb Haemost 4 (2006) 2569-2575
113. Nagajothi N., and Braverman A. Elevated red cell distribution width in the diagnosis of TTP patients presenting with anemia and thrombocytopenia. South Med J 100 (2007) 257-259
114. George J.N. The association of pregnancy with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Curr Opin Hematol 10 (2003) 339-344