Multidisciplinary team approach for an atypical presentation of postpartum thrombotic thrombocytopenic purpura and severe preeclampsia in the Intensive Care Unit

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare hematologic syndrome during pregnancy with overlapping features of severe preeclampsia and is associated with high morbidity and mortality. We present a case of postpartum TTP, associated with severe preeclampsia. Therapeutic approach for this case included corticosteroids, plasma exchange therapy, and immunomodulatory therapy. We describe the pathophysiology of TTP in pregnancy and its similarities with other disorders that constitute the thrombotic microangiopathy syndrome, as well as other clinical factors which made the final diagnosis challenging. In addition, we highlight the value of a multidisciplinary team care approach to assure an optimal outcome for this clinical scenario.

Keywords

• Multidisciplinary team approach; plasma exchange therapy; severe preeclampsia; thrombotic thrombocytopenic purpura