Does corticosteroid treatment cause prolonged recovery and increased total bilirubin level in severe ADAMTS-13-deficient TTP patient?

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dc.contributor.authorSayiner, Zeynel Abidin
dc.contributor.authorAcik, Didar Yanardag
dc.contributor.authorYilmaz, Mehmet
dc.contributor.authorSubari, Salih
dc.contributor.authorMete, Ayse Ozlem
dc.contributor.authorDai, M. Sinan
dc.date.accessioned2024-04-24T16:01:55Z
dc.date.available2024-04-24T16:01:55Z
dc.date.issued2015
dc.departmentDicle Üniversitesien_US
dc.description.abstractA 41-year-old female patient complaining of fatigue, headache, mild confusion, and rush on her lower extremities was admitted to our emergency department. Laboratory tests revealed that he had anemia, thrombocytopenia, and increased levels of indirect bilirubin and lactic dehydrogenase (LDH) in blood tests. Direct and indirect Coombs tests were negative, and fragmented erythrocytes were observed in peripheral blood smears. The patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). The best supportive care was provided. Therapeutic plasma exchange (TPE) and 1 mg/kg methylprednisolone treatments were administered. On the 10th day of treatment, LDH level and fragmented red blood cells in peripheral blood smear were decreased, but his direct and indirect bilirubin levels increased despite the fact that he was treated with 1 mg/kg methylprednisolone and TPE. The patient had severe ADAMTS-13 deficiency. After discontinued steroids treatment, his bilirubin level normalized within 4 days. On the 4th day after bilirubin level normalized, vincristine treatment was administered. TPE was also continued. There was no consensus about the optimal schedule for discontinuing plasmapheresis therapy, and also we observed total bilirubin level improvement with discontinued corticosteroid treatment. In this case, corticosteroid treatment was linked with the increase of total bilirubin level in severe ADAMTS-13-deficient TTP patient.en_US
dc.identifier.doi10.1007/s00508-014-0691-5
dc.identifier.endpage798en_US
dc.identifier.issn0043-5325
dc.identifier.issn1613-7671
dc.identifier.issue19-20en_US
dc.identifier.pmid25576335
dc.identifier.scopus2-s2.0-84943775628
dc.identifier.scopusqualityQ1
dc.identifier.startpage795en_US
dc.identifier.urihttps://doi.org/10.1007/s00508-014-0691-5
dc.identifier.urihttps://hdl.handle.net/11468/14492
dc.identifier.volume127en_US
dc.identifier.wosWOS:000362900000008
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringer Wienen_US
dc.relation.ispartofWiener Klinische Wochenschrift
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectTtpen_US
dc.subjectHemolysisen_US
dc.subjectTpeen_US
dc.subjectCorticosteroid Treatmenten_US
dc.subjectSevere Adamts-13 Deficiencyen_US
dc.titleDoes corticosteroid treatment cause prolonged recovery and increased total bilirubin level in severe ADAMTS-13-deficient TTP patient?en_US
dc.titleDoes corticosteroid treatment cause prolonged recovery and increased total bilirubin level in severe ADAMTS-13-deficient TTP patient?
dc.typeArticleen_US

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