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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2000 October;66(10):765-9
Thrombotic thrombocytopenic purpura (TTP) or Moschowitz’s syndrome. Personal experience
Iannandrea G., Flocco R., Flocco M.
Azienda Sanitaria Locale n. 3 Presidio Ospedaliero «Cardarelli» - Campobasso Servisio di Anestesia e Rianimazione (Dirigente Medico di II Livello: Dott. L. Iannandrea)
Aim. The aim of this study was to report that Moschcowitz’s syndrome was an inexorable cause of death in our Centre in the cases we observed, all of which failed to respond to the treatment used. This severe prognosis was attributed to the irreversible nature of the pathology when the patients were admitted to intensive care.
Methods. Three cases are described which were brought to our attention with this pathology. The following association was present in all cases: low platelet count, anemia with schistocytosis and indirect hyperbilirubinemia. Plasmapheresis was the main treatment used in all cases. Setting: the intensive care unit of our Hospital is the regional reference centre where plasmapheresis is performed. Patients: three patients were studied: two females aged 62 and 42 respectively, and one male aged 63. All three patients came from this region and no special features were found in their long-term medical history. Interventions: all patients underwent blood transfusion, plasmapheresis and received targeted antibiotic and corticosteroid treatment, and parenteral nutrition.
Results. All three cases died.
Conclusions. The analysis of these cases highlights the need for an early diagnosis, even if this is not easy, in order to commence successful therapy.