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2024, Number 1

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Cir Columna 2024; 2 (1)

Impact of orthopedic management, including spine surgery, on the outcome of patients with prothrombotic thrombocytopenic purpura: a clinical perspective

Lira-González FÁ, Jiménez-Ávila JM, Ruiz-Alonso PM, García-Lamas L, García-Hernández D, Guzmán-Silahua S, Rubio-Jurado B, Nava-Zavala AH

Language: Spanish
References: 41
Page: 40-47
PDF size: 218.21 Kb.


ABSTRACT

Prothrombotic thrombocytopenic purpura (PTT), a rare but severe disease characterized by thrombus formation in the microvasculature, leading to severe thrombocytopenia and microangiopathic hemolytic anemia. The pathogenesis of PTT centers on deficiency of the metalloprotease ADAMTS13, which is crucial for the regulation of von Willebrand factor and prevention of excessive thrombus formation. Diagnosis is based on clinical and laboratory findings, including reduced ADAMTS13 activity and the presence of autoantibodies in acquired cases. The relationship between PTT and orthopedic surgery is complex, given the potential exacerbation of thrombotic microangiopathy by surgical stress and endothelial damage. Documented cases are discussed where PTT manifested after orthopedic procedures, suggesting a link between surgery and activation of the underlying PTT pathology. Management of patients with PTT in the orthopedic setting requires a careful approach, especially in the selection of antiplatelet drugs and antimicrobial prophylaxis, due to their potential to trigger or exacerbate PTT. Education and awareness of the risks associated with surgery in patients with PTT are crucial to prevent complications and improve outcomes. In conclusion, the importance of a multidisciplinary approach in the management of patients with PTT undergoing orthopedic procedures, including spine surgery, is emphasized. Identification of risk factors, careful monitoring, and collaboration between hematologists and orthopedists are critical to minimize risks and optimize the care of these patients.


REFERENCES

  1. Singer K, Bornstein FP, Wile SA. Thrombotic thrombocytopenic purpura. Blood. 1947;2(6):542-554. Blood. 2016; 127: 169.

  2. Sukumar S, Lammle B, Cataland SR. Thrombotic thrombocytopenic purpura: pathophysiology, diagnosis, and management. J Clin Med. 2021; 10: 536.

  3. Joseph A, Joly BS, Picod A, Veyradier A, Coppo P. The specificities of thrombotic thrombocytopenic purpura at extreme ages: a narrative review. J Clin Med. 2023; 12: 3068.

  4. Furlan M, Robles R, Galbusera M, Remuzzi G, Kyrle PA, Brenner B, et al. von Willebrand factor-cleaving protease in thrombotic thrombocytopenic purpura and the hemolytic-uremic syndrome. N Engl J Med. 1998; 339: 1578-1584.

  5. Du P, Cristarella T, Moride Y. A Systematic Review of the Current Epidemiology of Immune-Mediated and Congenital Thrombotic Thrombocytopenic Purpura caused by Severe ADAMTS13 Deficiencies [abstract]. [Accessed January 26, 2024] Available in: https://abstracts.isth.org/abstract/a-systematic-review-of-the-current-epidemiology-of-immune-mediated-and-congenital-thrombotic-thrombocytopenic-purpura-caused-by-severe-adamts13-deficiencies/

  6. Adeyemi A, Razakariasa F, Chiorean A, de Passos Sousa R. Epidemiology, treatment patterns, clinical outcomes, and disease burden among patients with immune-mediated thrombotic thrombocytopenic purpura in the United States. Res Pract Thromb Haemost. 2022; 6: e12802.

  7. Kremer Hovinga JA, Coppo P, Lammle B, Moake JL, Miyata T et al. Thrombotic thrombocytopenic purpura. Nat Rev Dis Primers. 2017; 3: 17020.

  8. Mingot Castellano ME, Pascual Izquierdo C, González A, Viejo Llorente A, Valcarcel Ferreiras D, Sebastián E, et al. Recomendaciones para el abordaje clínico de pacientes con púrpura trombocitopénica trombótica. Med Clin. 2022; 158: 630.e1-.e14.

  9. Sukumar S, Gavriilaki E, Chaturvedi S. Updates on thrombotic thrombocytopenic purpura: Recent developments in pathogenesis, treatment and survivorship. Thrombosis Update. 2021; 5: 100062.

  10. Guillén López OB. Púrpura trombocitopénica trombótica sin esquistocitos. Revista Médica Herediana [Internet]. 2019; 30: 56. Disponible en: https://revistas.upch.edu.pe/index.php/RMH/article/view/3475

  11. Sadler JE. Pathophysiology of thrombotic thrombocytopenic purpura. Blood. 2017; 130: 1181-1188.

  12. Tsai HM. Pathophysiology of thrombotic thrombocytopenic purpura. Int J Hematol. 2010; 91: 1-19.

  13. Borogovac A, Reese JA, Gupta S, George JN. Morbidities and mortality in patients with hereditary thrombotic thrombocytopenic purpura. Blood Adv. 2022; 6: 750-759.

  14. Ben Saida I, Maatouk I, Toumi R, Bouslama E, Ben Ismail H, Ben Salem C, et al. Acquired thrombotic thrombocytopenic purpura following inactivated COVID-19 vaccines: two case reports and a short literature review. Vaccines (Basel). 2022; 10: 1012.

  15. Vacca VM Jr. Acquired autoimmune thrombotic thrombocytopenic purpura. Nursing. 2019; 49: 22-29.

  16. Bayer G, von Tokarski F, Thoreau B, Bauvois A, Barbet C, Cloarec S, et al. Etiology and outcomes of thrombotic microangiopathies. Clin J Am Soc Nephrol. 2019; 14: 557-566.

  17. Patel NN, Shah JA, Sadlack CK. Postoperative thrombotic thrombocytopenic purpura after total hip arthroplasty: a case report and review of the literature. Case Rep Orthop. 2018; 2018: 9716170.

  18. Iosifidis MI, Ntavlis M, Giannoulis I, Malioufas L, Ioannou A, Giantsis G. Acute thrombotic thrombocytopenic purpura following orthopedic surgery: a case report. Arch Orthop Trauma Surg. 2006; 126: 335-338.

  19. Yenigun EC, Bardak S, Piskinpasa SV, Oztürk R, Turgut D, Koc E, et al. Acute thrombotic thrombocytopenic purpura following orthopedic surgery: case report and review of the literature. Ren Fail. 2012; 34: 937-939.

  20. Naqvi TA, Baumann MA, Chang JC. Post-operative thrombotic thrombocytopenic purpura: a review. Int J Clin Pract. 2004; 58: 169-172.

  21. Eskazan AE, Salihoglu A, Gulturk E, Ongoren S, Soysal T. Thrombotic thrombocytopenic purpura after prophylactic cefuroxime axetil administered in relation to a liposuction procedure. Aesthetic Plast Surg. 2012; 36: 464-467.

  22. Sturtzel C. Endothelial cells. Adv Exp Med Biol. 2017; 1003: 71-91.

  23. Cauchois R, Muller R, Lagarde M, Dignat-George F, Tellier E, Kaplanski G. Is endothelial activation a critical event in thrombotic thrombocytopenic purpura? J Clin Med. 2023; 12: 758.

  24. Kathula SK, Kamana M, Naqvi T, Gupta S, Chang JC. Acute thrombotic thrombocytopenic purpura following orthopedic surgery. J Clin Apher. 2002; 17: 133-134.

  25. Faisal M, Ul Aein Q, Saeed A, Mumtaz A, Larik FA. Highly productive and scalable approach to synthesize ticlopidine: A potent thienopyridine anti-platelet aggregation drug. Heliyon. 2020; 6: e05731.

  26. Bennett CL, Davidson CJ, Raisch DW, Weinberg PD, Bennett RH, Feldman MD. Thrombotic thrombocytopenic purpura associated with ticlopidine in the setting of coronary artery stents and stroke prevention. Arch Intern Med. 1999; 159: 2524-2528.

  27. Magee C, Spiegel M, Wiggins B, Lim M. 528: clopidogrel-induced thrombotic thrombocytopenic purpura with successful transition to ticagrelor. Critical Care Medicine. 2020; 48: 245.

  28. Rubano JA, Chen K, Sullivan B, Vosswinkel JA, Jawa RS. Clopidogrel-associated thrombotic thrombocytopenic purpura following endovascular treatment of spontaneous carotid artery dissection. J Neurol Surg Rep. 2015;76: e287-e290.

  29. Ndulue CN, Jisieike-Onuigbo NN, Okwesa NJ, Anyanor A, Ozuemba BC, Osakwe N, et al. Clopidogrel-induced thrombotic thrombocytopenic purpura: a case report. Afr Health Sci. 2023; 23: 592-595.

  30. Patti G, Micieli G, Cimminiello C, Bolognese L. The role of clopidogrel in 2020: a reappraisal. Cardiovasc Ther. 2020; 2020: 8703627.

  31. Duarte JD, Cavallari LH. Pharmacogenetics to guide cardiovascular drug therapy. Nat Rev Cardiol. 2021; 18: 649-665.

  32. Morales-Montoya A. Púrpura trombocitopénica trombótica. Med Int Méx. 2019; 35: 906-911.

  33. Zhu H, Liu JY. Thrombotic thrombocytopenic purpura with neurological impairment: A Review. Medicine (Baltimore). 2022; 101: e31851.

  34. Kalish Y, Rottenstreich A, Rund D, Hochberg-Klein S. Atypical presentations of thrombotic thrombocytopenic purpura: a diagnostic role for ADAMTS13. J Thromb Thrombolysis. 2016; 42: 155-160.

  35. Berber I, Erkurt MA, Kuku I, Kaya E, Unlu S, Ertem K, et al. Thrombotic thrombocytopenic purpura presenting with pathologic fracture: a case report. Transfus Apher Sci. 2014; 51: 73-76.

  36. Favaloro EJ, Pasalic L, Henry B, Lippi G. Laboratory testing for ADAMTS13: utility for TTP diagnosis/exclusion and beyond. Am J Hematol. 2021; 96: 1049-1055.

  37. Joly BS, Coppo P, Veyradier A. An update on pathogenesis and diagnosis of thrombotic thrombocytopenic purpura. Expert Rev Hematol. 2019; 12: 383-395.

  38. Zheng XL, Vesely SK, Cataland SR, Coppo P, Geldziler B, Iorio A, et al. ISTH guidelines for the diagnosis of thrombotic thrombocytopenic purpura. J Thromb Haemost. 2020; 18: 2486-2495.

  39. Asmis LM, Serra A, Krafft A, Licht A, Leisinger E, Henschkowski-Serra J, et al. Recombinant ADAMTS13 for hereditary thrombotic thrombocytopenic purpura. N Engl J Med. 2022; 387: 2356-2361.

  40. Jain N, Marquez C, Martell L. Recombinant ADAMTS13 for patients with severe congenital thrombotic thrombocytopenic purpura: design of a phase 3b open-label continuation study of prophylactic and on-demand treatment. Blood. 2021; 138: 4252.

  41. Graca NAG, Joly BS, Voorberg J, Vanhoorelbeke K, Beranger N, Veyradier A, et al. TTP: From empiricism for an enigmatic disease to targeted molecular therapies. Br J Haematol. 2022; 197: 156-170.




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