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- W2046175302 abstract "A RARE CASE OF REBIF INDUCED THROMBOTIC THROMBOCYTOPENIC PURPURA Geetha Seerangan, Mozzam Sana, Nimrit Goraya Scott & White Hospital, Temple, Texas, USA Thrombotic thrombocytopenic purpura (TTP) is a rare disorder of the blood-coagulation system, causing extensive microscopic thromboses to form in small blood vessels throughout the body (thrombotic microangiopathy (TMA)). Most cases of TTP arise from inhibition of the enzyme ADAMTS13. Current therapy is plasmapheresis to reduce Abs against ADAMTS13 and replenish levels. Here we report a case of TTP, occurring in a 33-year old Caucasian female, induced by Rebif (Interferon beta-1a). Patient initially presented to the hospital in October 2010 with 3 day history of nausea, vomiting, generalized weakness, fatigue and lower extremity edema. Labs showed creatinine of 4.1, hemoglobin (Hb) of 6.9 and platelets of 99 with prior normal labs in April 2010. Urinalysis showed greater than 600 mg/dL of protein, 3+ blood, few dysmorphic RBC’s with RBC casts on microscopy. She has history of multiple sclerosis and was on Rebif 44 mcg subcutaneous 3 times a week starting Dec 2009. Rebif was discontinued and she had renal biopsy which showed TMA with focal glomerulosclerosis. Serological tests were all negative except for low C3 complement levels. ADAMTS13 level was 28%. Patient was started on plasmapheresis ,steroids,4 doses of Rituxan and then started on hemodialysis secondary to anuric acute kidney injury. After 2 weeks of pheresis, repeat ADAMTS13 level increased to 74% with improved platelet levels. Incidence rate of TTP with use of Rebif is 8%. Plasma exchange and discontinuation of Rebif replenished the ADAMTS13 and platelet levels. So far 5 cases of TTP have been reported secondary to Rebif with two patients requiring renal transplant." @default.
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- W2046175302 date "2011-04-01" @default.
- W2046175302 modified "2023-09-23" @default.
- W2046175302 title "277 A Rare Case of Rebif Induced Thrombotic Thrombocytopenic Purpura" @default.
- W2046175302 doi "https://doi.org/10.1053/j.ajkd.2011.02.280" @default.
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