Therapeutic Plasma Exchange Improved Pregnancy-associated Thrombotic Microangiopathy but not the Pregnancy Outcome in Patient with Systemic Lupus Erythematosus
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- Terasaki Toshihiko
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Kondo Yuya
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Takahashi Mayumi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Tawara Takashi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Fujita Akiko
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Yagi Hiroya
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Japan
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- Kawai Hitomi
- Department of Pathology, Institute of Basic Sciences, University of Tsukuba, Japan
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- Noguchi Masayuki
- Department of Pathology, Institute of Basic Sciences, University of Tsukuba, Japan
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- Sato Ryota
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Terasaki Mayu
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Okamoto Shota
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Toko Hirofumi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Yagishita Mizuki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Takahashi Hiroyuki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Hagiwara Shinya
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Tsuboi Hiroto
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Matsumoto Isao
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- 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
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- Internal Medicine
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Internal Medicine 59 (24), 3235-3238, 2020-12-15
The Japanese Society of Internal Medicine