ASFA Category IV becomes Category I: Idiopathic thrombotic thrombocytopenic purpura in a patient with presumed gemcitabine-induced thrombotic microangiopathy.

Journal Article

In the implementation of American Society for Apheresis national guidelines, the decision for therapeutic plasma exchange may be confounded by a clinical presentation that fits both a Category I and IV designation. We report the case of a 45-year-old female who presented with concern for a Category IV disorder, gemcitabine-induced thrombotic microangiopathy, and was ultimately diagnosed with a Category I disorder, idiopathic thrombotic thrombocytopenic purpura. This case highlights the importance of ruling out idiopathic TTP by a thorough evaluation for ADAMTS13 activity and inhibitor, even when an alternate thrombotic microangiopathy diagnosis may be likely.

Full Text

Duke Authors

Cited Authors

  • Bittar, PG; Nickolich, MS; Onwuemene, OA

Published Date

  • June 2018

Published In

Volume / Issue

  • 33 / 3

Start / End Page

  • 423 - 426

PubMed ID

  • 28940604

Pubmed Central ID

  • PMC6852620

Electronic International Standard Serial Number (EISSN)

  • 1098-1101

Digital Object Identifier (DOI)

  • 10.1002/jca.21590


  • eng

Conference Location

  • United States