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

  • Terasaki Toshihiko
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Kondo Yuya
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Takahashi Mayumi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Tawara Takashi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Fujita Akiko
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Yagi Hiroya
    Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Japan
  • Kawai Hitomi
    Department of Pathology, Institute of Basic Sciences, University of Tsukuba, Japan
  • Noguchi Masayuki
    Department of Pathology, Institute of Basic Sciences, University of Tsukuba, Japan
  • Sato Ryota
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Terasaki Mayu
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Okamoto Shota
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Toko Hirofumi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Yagishita Mizuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Takahashi Hiroyuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Hagiwara Shinya
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Tsuboi Hiroto
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Matsumoto Isao
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Sumida Takayuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan

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Description

<p>Thrombotic 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. </p>

Journal

  • Internal Medicine

    Internal Medicine 59 (24), 3235-3238, 2020-12-15

    The Japanese Society of Internal Medicine

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