Thrombotic thrombocytopenic purpura as the first manifestation of metastatic adenocarcinoma in a young woman

Kadıköylü, Gürhan; Barutça, Sabri; Tataroğlu, Canten; Kafkas, Samet; Erpek, Hakan; Meydan, Nezih; Yavaşoğlu, İrfan

doi:10.1016/j.transci.2009.10.010

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…Only 40% of TTP cases have the complete pentad and in 75% of the cases there is a triad of microangiopathic hemolytic anemia, thrombocytopenia, and neurological findings [7]. At present, the diagnosis of TTP is considered with microangiopathic hemolytic anemia and thrombocytopenia when any other cause is excluded [7]. In our case there was no acute kidney failure; however, all the other features favored TTP, and the diagnosis was made without kidney failure.…”

Section: Discussionmentioning

confidence: 73%

“…Moreover, in some patients, the diagnosis of TTP may not be made until the laboratory test reveals severe thrombocytopenia and MAHA. Only 40% of TTP cases have the complete pentad and in 75% of the cases there is a triad of microangiopathic hemolytic anemia, thrombocytopenia, and neurological findings [7]. At present, the diagnosis of TTP is considered with microangiopathic hemolytic anemia and thrombocytopenia when any other cause is excluded [7].…”

Section: Discussionmentioning

confidence: 99%

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A Signet Ring Cell Carcinoma Presented as Refractory Acquired Thrombotic Thrombocytopenic Purpura

et al. 2020

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Microangiopathic hemolytic anemia (MAHA) can be observed as a paraneoplastic syndrome (PS) in certain tumors. MAHA-related signet ring cell carcinoma (SRCC) of an unknown origin is very infrequent. Herein we present a SRCC case presented with refractory acquired thrombotic thrombocytopenic purpura (TTP). A 35-year-old man applied to the emergency service with fatigue and headache. His laboratory tests resulted as white blood cell 9,020/µL, hemoglobin 3.5 g/dL, platelet 18,000/µL. Schistocytes, micro-spherocytes, and thrombocytopenia were observed in his blood smear. MAHA was present and he was considered as having TTP. Plasma exchange treatment was initiated; however, he was refractory to this treatment. Thorax and abdomen computerized tomography revealed thickening of minor curvature in stomach corpus with hepatogastric and paraceliac lymphadenopathy. Bone marrow (BM) investigation by our clinic resulted as the metastasis of adenocarcinoma. Ulceration and necrosis were observed by gastric endoscopy procedure. Biopsy was taken during endoscopic intervention, which resulted as SRCC. MAHA may be seen as a PS in some tumors, especially gastric cancers. Tumor-related MAHA is generally accompanied by BM metastases. As a result, BM investigation may be used as the main diagnostic method to find the underlying cancer. The clinical course of cases with tumor-related MAHA is usually poor, and these cases are usually refractory to plasma exchange treatment. In conclusion, physicians should suspect a malignancy and BM involvement when faced with a case of refractory TTP.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

A Signet Ring Cell Carcinoma Presented as Refractory Acquired Thrombotic Thrombocytopenic Purpura

et al. 2020

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“…Eight patients had been previously diagnosed with and treated for gastric cancer, so their haematological derangements heralded disease recurrence. Only two patients were reported to have q2weekly -neurological symptoms (including confusion, disorientation and seizure) while none of the cases reported associated renal dysfunction (9,13). This contrasts with neurological and renal involvement typically associated with primary TMA syndromes such as ADAMTS13 deficiency-mediated TMA and Shiga toxin-mediated TMA [previously known as thrombocytopenic purpura (TTP) and haemolytic-uraemic syndrome (HUS), respectively] (1).…”

Section: Discussionmentioning

confidence: 99%

The role of chemotherapy in gastric cancer-related microangiopathic haemolytic anaemia

Tang

Goldstein

2017

J. Gastrointest. Oncol.

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We report a case of a previously well 46-year-old man who presented with microangiopathic haemolytic anaemia (MAHA) of unknown origin. After extensive investigations, he was diagnosed with cancer-related microangiopathic haemolytic anaemia (CR-MAHA) secondary to gastric adenocarcinoma. Initial treatment with plasmapheresis was ineffective, but the patient's haematological abnormalities improved markedly with chemotherapy directed against his gastric cancer. Our case amplifies previous experience of gastric cancer-associated MAHA which responded to treatment with chemotherapy. We review current understanding of the proposed pathophysiology of CR-MAHA and conclude that this condition is ideally treated with chemotherapy.

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Terminological discrepancies and novelties in the histological description of the female genital system: proposed amendments for clinical-translational anatomy

Varga,

Hammer,

Pavlíková

et al. 2024

Anat Sci Int

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Histological terminology of the female genital organs is currently a part of the internationally accepted nomenclature Terminologia Histologica (TH), the latest edition of which dates back to 2008. Many new discoveries have been documented within 16 years since then, and many discrepancies have been found. This paper aims to revise the terminology from clinical and educational perspectives comprehensively. The authors thoroughly searched the current edition of “Terminologia Histologica: International Terms for Human Cytology and Histology,” focusing on missing and controversial terms in the chapter Female genital system. The authors identified six controversial and ambiguous terms and four missing important histological terms. The authors also discussed the addition of less used eponymic terms in the histological description of female genital organs like Hamperl cells, Popescu cells, Kroemer lacunae, Balbiani bodies, Call–Exner bodies, membrane of Slavianski, nabothian cysts, or anogenital sweat glands of van der Putte. We expect the second and revised edition of the TH to be published soon and hope that the Federative International Program on Anatomical Terminology will approve and incorporate all these propositions and suggestions. We also strongly recommend using the official internationally accepted Latin and English histological nomenclature—the TH, either in oral or written form, both in theoretical and clinical medicine.

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Thrombotic thrombocytopenic purpura as the first manifestation of metastatic adenocarcinoma in a young woman

Cited by 9 publications

References 26 publications

A Signet Ring Cell Carcinoma Presented as Refractory Acquired Thrombotic Thrombocytopenic Purpura

A Signet Ring Cell Carcinoma Presented as Refractory Acquired Thrombotic Thrombocytopenic Purpura

The role of chemotherapy in gastric cancer-related microangiopathic haemolytic anaemia

Terminological discrepancies and novelties in the histological description of the female genital system: proposed amendments for clinical-translational anatomy

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