• Internal medicine · Dec 2020

    Case Reports

    Therapeutic Plasma Exchange Improved Pregnancy-associated Thrombotic Microangiopathy but not the Pregnancy Outcome in Patient with Systemic Lupus Erythematosus.

    • Toshihiko Terasaki, Yuya Kondo, Mayumi Takahashi, Takashi Tawara, Akiko Fujita, Hiroya Yagi, Hitomi Kawai, Masayuki Noguchi, Ryota Sato, Mayu Terasaki, Shota Okamoto, Hirofumi Toko, Mizuki Yagishita, Hiroyuki Takahashi, Shinya Hagiwara, Hiroto Tsuboi, Isao Matsumoto, and Takayuki Sumida.
    • Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan.
    • Intern. Med. 2020 Dec 15; 59 (24): 3235-3238.

    AbstractThrombotic microangiopathy (TMA) is a rare but life-threatening complication of systemic lupus erythematosus (SLE) and is associated with adverse pregnancy outcomes. We herein report a 30-year-old pregnant woman with SLE complicated by TMA. Because her condition was unresponsive to initial corticosteroid and fresh-frozen plasma infusion treatment, we attempted plasma exchange (PE). Although thrombocytopenia and microangiopathic hemolytic anemia gradually improved, fetal death was confirmed at 23 weeks of gestation. This case suggests that PE is an effective therapeutic option but might be insufficient to maintain pregnancy in patients with SLE complicated by TMA.

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