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Etiological evaluation and the role of plasma exchange treatment in trombotic microangiopathies: A retrospective analysis from Eastern Anatolia

Emine Hidayet, Mehmet Ali Erkurt, Ahmet Sarici, Soykan Bicim, Irfan Kuku, Ilhami Berber, Emin Kaya, Ahmet Kaya, Mustafa Ozgul, Ayse Uysal.




Abstract

The aim is this study was to make the etiological classification of patients diagnosed with TMA in our region and to statistically evaluate the effect of therapeutic plasma exchange, which we use in treatment, on laboratory recovery and mortality. In our study, between 2009-2017, 85 patients diagnosed with TMA in our center evaluated retrospectively. Thirty- one (36.5%) of our patients were followed up with HELLP, 23 with thrombotic thrombocytopenic purpura (TTP) (27.1%), 20 (23.5%) snake bites, and 11 (12.9%) with atypical hemolytic uremic syndrome (aHUS). TPE treatment was performed in all patients. TPE treatment was found effective in patients with HELLP syndrome, TTP and snake bite and statistically significant improvement was obtained in laboratory parameters (p0.05). Mortality rates were found 9.7%, 21.7%, 27.3%, and 0% in patients with HELLP Syndrome, TTP, aHUS, and snake bite, respectively. The primary treatment in HELLP syndrome was termination of pregnancy, it was observed in our study that TPE was effective in TTP, HELLP syndrome and snake bites and treatment should be started without delay.

Key words: Thrombotic microangiopathy, therapeutic plasma exchange, HELLP syndrome, thrombotic thrombocytopenic purpura, atypical hemolytic uremic syndrome






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