VOLUME 12 , ISSUE 4 ( July-August, 2020 ) > List of Articles
Anupama Bhute, Neema Acharya
Citation Information : Bhute A, Acharya N. Moschcowitz Syndrome or Thrombotic Thrombocytopenic Purpura and Antiphospholipid Antibody Syndrome as a Rare Cause of Thrombocytopenia in Pregnancy Mimicking Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome in a Patient with Bad Obstetric History: A Diagnostic Dilemma. J South Asian Feder Obs Gynae 2020; 12 (4):250-253.
DOI: 10.5005/jp-journals-10006-1791
License: CC BY-NC 4.0
Published Online: 28-09-2020
Copyright Statement: Copyright © 2020; The Author(s).
Thrombotic microangiopathy (TMA) is a group of disorders characterized by microangiopathic hemolytic anemia, moderate to severe thrombocytopenia, and end-organ damage. In pregnancy, TMA is most commonly due to preeclampsia and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. Very rarely it occurs due to Moschowitz syndrome also known as thrombotic thrombocytopenic purpura (TTP), antiphospholipid antibody (APLA) syndrome, or atypical hemolytic uremic syndrome (aHUS). All of these share common clinical features; yet their etiologies are different. Although both HELLP and TTP share common features of endothelial injury and microvascular thrombi, yet, they have different courses and line of management. In term pregnancy, differentiating between these two pathologies can be extremely difficult due to the extreme overlap in clinical and laboratory manifestations, and this becomes possible only with the use of specific markers as ADAMTS-13, whenever available. Unfortunately, delay in timely diagnosis and treatment can be life-threatening. We describe case of 25-year-old pregnant woman who came with HELLP syndrome which did not resolve postpartum only to improve after plasmapheresis.
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