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Thrombotic thrombocytopenic purpura with complete molar pregnancy: a case report
Hongmei Meng1, Nirmala S Kumar, Jyothi Nannapaneni
1Department of Obstetrics and Gynecology, Jamaica Hospital Medical Center, Jamaica, New York 11418, USA. menghmei@gmail.com
Background:
Thrombotic thrombocytopenic purpura (TTP) is extremely rare. This disease and its prompt diagnosis are important because TTP in pregnancy carries a 90% mortality rate.
Case:
A 21-year-old woman underwent suction dilation and curettage for molar pregnancy. Postoperatively the patient developed severe hypertension, microangiopathic anemia, thrombocytopenia and chest pain associated with ischemic cardiac changes. Despite blood and plasma transfusions and steroid therapy, the patient continued to have worsening hemolysis and thrombocytopenia. TTP was diagnosed, and plasmapheresis led to a rapid recovery.
Conclusion:
TTP can occur with molar pregnancy. Making this diagnosis in a timely manner is crucial to ensure that potentially life-saving plasmapheresis is initiated in a timely manner. To our knowledge, this is the first reported case of thrombotic thrombocytopenic purpura with molar pregnancy.
