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Intern Med ; 50(5): 487-93, 2011.
Article in English | MEDLINE | ID: mdl-21372465

ABSTRACT

A 26-year-old woman with a history of mild mental retardation, Charcot-Marie-Tooth disease (CMT) and idiopathic thrombocytopenic purpura developed severe thrombocytopenia with Coombs-negative hemolytic anemia. Magnetic resonance imaging revealed a fresh cerebral infarction in the left precentral gyrus. ADAMTS-13 deficiency caused by an inhibitor and anti-cardiolipin antibodies were detected in the blood. After treatment with prednisolone and fresh frozen plasma, ADAMTS-13 activity was normalized, the ADAMTS-13 inhibitor had disappeared and the thrombocytopenia with a bleeding tendency was improved. To our knowledge, this is the first case of thrombotic thrombocytopenic purpura caused by ADAMTS-13 deficiency associated with antiphospholipid antibodies and CMT.


Subject(s)
ADAM Proteins/deficiency , Antiphospholipid Syndrome/complications , Charcot-Marie-Tooth Disease/complications , ADAM Proteins/antagonists & inhibitors , ADAM Proteins/blood , ADAMTS13 Protein , Adult , Antibodies, Anticardiolipin/blood , Antiphospholipid Syndrome/blood , Antiphospholipid Syndrome/immunology , Charcot-Marie-Tooth Disease/immunology , Female , Humans , Plasma , Platelet Transfusion , Prednisolone/therapeutic use , Purpura, Thrombotic Thrombocytopenic/blood , Purpura, Thrombotic Thrombocytopenic/etiology , Purpura, Thrombotic Thrombocytopenic/immunology , Purpura, Thrombotic Thrombocytopenic/therapy
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