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01-01-2020 | Thrombotic Thrombocytopenic Purpura

A case of acute pancreatitis-induced microangiopathic hemolytic anemia with thrombocytopenia

Authors: Kevin M. Hill, Danielle Moorman, Jonathan Mack, Carol Gonsalves, Roy Khalife

Published in: Journal of Thrombosis and Thrombolysis | Issue 1/2020

Abstract

Microangiopathic hemolytic anemia and thrombocytopenia (MAHA-T) is a rare complication of acute pancreatitis (AP). Treatment with therapeutic plasma exchange (TPE) is used at many centers. The natural history of this disease is not well understood. We report a case of acute pancreatitis induced MAHA-T with end organ dysfunction and a normal ADAMTS13 level. Following three TPEs, the patient’s clinical status, blood counts and hemolytic markers stabilized. Improvement occurred even after TPE was discontinued. The optimal management of AP-induced MAHA-T is poorly understood. Many centres are reporting good outcomes with the early initiation of TPE. MAHA-T associated with acute pancreatitis is often treated with early initiation of TPE. However, the value of TPE in altering the natural history of the condition is not well understood. Further study is required to understand the role of ADAMTS13 testing to guide treatment, and the role of TPE in management.

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Title: A case of acute pancreatitis-induced microangiopathic hemolytic anemia with thrombocytopenia
Authors: Kevin M. Hill
Danielle Moorman
Jonathan Mack
Carol Gonsalves
Roy Khalife
Publication date: 01-01-2020
Publisher: Springer US
Keywords: Thrombotic Thrombocytopenic Purpura
Acute Pancreatitis
Thrombotic Microangiopathy
Pancreatitis
Thrombocytopenia
Hemolytic Anemia
Published in: Journal of Thrombosis and Thrombolysis / Issue 1/2020
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-019-01946-2

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