血液疾患と輸血ジャーナル

概要

Autoimmune Derangement in a Patient with Simultaneous Diagnoses of Primary Anti phospholipid Syndrome, Thrombotic Thrombocytopenic Purpura and Heparin Induced Thrombocytopenia

Komal Khiani, Yair Keilson, Philip Rubin, William Solomon, Yevgenia Margulis, Yiwu Huang and Yiqing Xu

Primary antiphospholipid syndrome (APS), thrombotic thrombocytopenic purpura (TTP) and heparin induced thrombocytopenia (HIT) are all hypercoagulable conditions characterized by thrombocytopenia and high risks of thrombosis. A severe form of APS, namely catastrophic antiphospholipid syndrome (CAPS), further shares features with TTP by the presence of microangiopathic hemolytic anemia characterized by schistocytes on the blood smear. CAPS and TTP may be co-existing and an underlying autoimmune association was postulated. Here we report a patient who presented with initial symptoms of APS, who then simultaneously developed TTP and HIT after being exposed to Clopidogrel and Heparin. Our case suggests that the autoimmune deregulation in APS predisposes the patient to other immune related conditions.