&lt;i&gt;Mycoplasma-pneumoniae&lt;/i&gt;-Induced Thrombotic Thrombocytopenic Purpura

Meir, E Bar; Amital, H; Levy, Yaron Y.; Kneller, Abraham; Bar‐Dayan, Yaron; Shoenfeld, Y.

doi:10.1159/000041030

Cited by 56 publications

(30 citation statements)

References 12 publications

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“…It has been attributed to cross-reacting cold agglutinins, and may be accompanied by renal failure [8,12,13] . Even rarer is the association between Mycoplasma infection and thrombotic throm- bocytopenic purpura or disseminated intravascular coagulation [14,15] .…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Hemolytic Anemia Secondary to Mycoplasma pneumoniae Infection

Carrara

Abbate

Sabadini³

2017

Nephron

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Glomerulonephritis as well as kidney injury secondary to fulminant intravascular hemolysis are rare extrapulmonary manifestations of Mycoplasma pneumoniae infection. We describe a 50-year-old female diagnosed with M. pneumoniae infection-associated hemolytic anemia, characterized by negative cold agglutinin tests but with laboratory evidence of complement alternative pathway activation. The patient presented both with anemia and severe kidney failure and she was treated with steroids and red blood cell transfusions along with plasmapheresis. She also received a short course of antibiotics. Renal biopsy showed combined features of resolving postinfectious glomerulonephritis and hemolysis-associated extensive acute tubular injury characterized by renal hemosiderosis and intratubular hemoglobin casts. Electron microscopy revealed features of glomerular microangiopathic injury. The treatment led to complete disease remission and a favorable renal outcome at the first year follow-up.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Hemolytic Anemia Secondary to Mycoplasma pneumoniae Infection

Carrara

Abbate

Sabadini³

2017

Nephron

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“…Two cases of aplastic anemia associated with M. pneumoniae have also been reported (390). A recent report suggests that thrombotic thrombocytopenic purpura associated with M. pneumoniae infection may be the result of cross-reactive antibodies inactivating plasma von Willebrand factor-cleaving protease (23). Fulminant infection leading to fatal disseminated intravascular coagulation has also been reported (73), as has a case of priapism in a 12-year-old boy that was felt to be due to the hypercoagulable state that sometimes occurs in association with M. pneumoniae infection (192).…”

Section: Extrapulmonary Manifestationsmentioning

confidence: 99%

“…However, the availability of PCR has greatly enhanced understanding of how M. pneumoniae can disseminate throughout the body. The presence of M. pneumoniae in extrapulmonary sites such as blood, synovial fluid and cerebrospinal fluid, pericardial fluid, and skin lesions has been documented by PCR as well as culture, so direct invasion must always be considered (23,220,235,306,360). However, the frequency of direct invasion of these sites is unknown because the organism is rarely sought for clinical purposes.…”

Section: Extrapulmonary Manifestationsmentioning

confidence: 99%

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

2004

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Mycoplasma pneumoniae is a unique bacterium that does not always receive the attention it merits considering the number of illnesses it causes and the degree of morbidity associated with it in both children and adults. Serious infections requiring hospitalization, while rare, occur in both adults and children and may involve multiple organ systems. The severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. The extrapulmonary manifestations are sometimes of greater severity and clinical importance than the primary respiratory infection. Evidence for this organism's contributory role in chronic lung conditions such as asthma is accumulating. Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones. As more is learned about the pathogenesis and immune response elicited by M. pneumoniae, improvement in methods for diagnosis and prevention of disease due to this organism may occur

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“…In addition, the term thrombotic microangiopathy (TM) has been introduced to include hemolytic uremic syndrome, hemolysis with elevated liver enzyme levels and a low platelet count (HELLP) syndrome, and dyadic TTP in addition to classical TTP. Secondary TM has been known to be associated with collagen vascular diseases [2][3][4][5], use of certain drugs [6][7][8][9], transplants [10][11][12][13], surgeries [14][15][16][17], infections [18,19], pregnancy [20,21], and cancer [22][23][24]. In cancer patients, at least two causes for TM have been identified.…”

Section: Introductionmentioning

confidence: 99%

Thrombotic Thrombocytopenic Purpura Associated with Bone Marrow Metastasis and Secondary Myelofibrosis in Cancer

Chang

Naqvi

2003

The Oncologist

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To examine the relationship between cancer and development of thrombotic microangiopathy (TM), the medical records of patients with known TM were examined in one institution from January 1981 to December 2002. Nine out of 93 patients with the established diagnosis of TM had active cancer. All nine of those patients had thrombotic thrombocytopenic purpura (TTP). Among those patients, two patients received chemotherapy prior to the development of TTP. Six of the seven patients who received no chemotherapy had extensive bone marrow metastasis and secondary myelofibrosis. There were two patients each with breast cancer, lung cancer, and stomach cancer. Severe anemia and thrombocytopenia with leukoerythroblastosis were prominent clinical features in all six patients. Four patients had neurological (mental) changes and three developed fever, but none had significant renal dysfunction. Upon establishing the diagnosis of TTP, four patients were treated with exchange plasmapheresis (EP) and two patients were treated with chemotherapy because there were no neurological changes. Three patients achieved complete remission of TTP, one with EP alone and two with chemotherapy. The one patient who achieved remission with EP alone was later treated with chemotherapy and survived for 2 1/2 years. The other three patients treated with EP alone died within 2 months after the diagnosis of TTP. Since TTP occurred in association with bone marrow metastasis and myelofibrosis in six patients among seven chemotherapy-untreated cancer patients, this marrow change was considered to be the possible cause of the development of TTP. It is recommended that all cancer patients with unexplained anemia and thrombocytopenia be evaluated for the coexistence of bone marrow metastasis and TTP.

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<i>Mycoplasma-pneumoniae</i>-Induced Thrombotic Thrombocytopenic Purpura

Cited by 56 publications

References 12 publications

Acute Kidney Injury and Hemolytic Anemia Secondary to <b><i>Mycoplasma pneumoniae</i></b> Infection

Acute Kidney Injury and Hemolytic Anemia Secondary to <b><i>Mycoplasma pneumoniae</i></b> Infection

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

Thrombotic Thrombocytopenic Purpura Associated with Bone Marrow Metastasis and Secondary Myelofibrosis in Cancer

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