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Thrombus Profiling Assay: A Microfluidics-Based Platform for Comprehensively Characterizing Biomechanical Thrombogenesis
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Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors: a

Kenneth W Douglas1, Kevin G J Pollock, David Young

  • 1Clinical Apheresis Unit, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. kenneth.douglas@nhs.net

Journal of Clinical Apheresis
|January 27, 2010
PubMed

Insights

Bacterial infection frequently triggers thrombotic microangiopathies, including thrombotic thrombocytopenic purpura (TTP). Early identification and management of infection are crucial for improving survival outcomes in these rare, life-threatening conditions.

Area of Science:

  • Hematology
  • Internal Medicine
  • Pathology

Background:

  • Thrombotic microangiopathies (TMAs) are rare, life-threatening disorders.
  • TMAs include hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP).
  • Characterized by microangiopathic hemolytic anemia, microthrombi, and multiorgan damage.

Purpose of the Study:

  • To analyze the clinical characteristics and outcomes of TMA patients.
  • To identify significant factors associated with survival in TMA.
  • To explore the role of bacterial infection as a trigger for TMAs.

Main Methods:

  • Retrospective analysis of 65 TMA patients treated between 1997 and 2008.
  • Therapeutic plasma exchange was a mandatory component of treatment for inclusion.
  • Multivariate analysis was used to identify predictors of survival.

Main Results:

  • The majority of patients (66%) were female, with a median age of 52 years.
  • Bacterial infection was the most frequent identified cause of TMA.
  • Bacterial infection was the sole significant predictor of survival (OR 5.1, 95% CI 1.2-21.7).

Conclusions:

  • Bacterial infection frequently triggers TTP and other TMAs in susceptible individuals.
  • Patients with hepatobiliary sepsis may benefit from cholecystectomy.
  • A model for TMA development involving bacterial triggers is proposed.

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