caa a22 4500 606241159 CHVBK 20210128101311.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00508-014-0691-5 doi (NATIONALLICENCE)springer-10.1007/s00508-014-0691-5 Does corticosteroid treatment cause prolonged recovery and increased total bilirubin level in severe ADAMTS-13-deficient TTP patient? [Elektronische Daten] [Zeynel Abidin Sayiner, Didar Yanardag Acik, Mehmet Yilmaz, Salih Subari, Ayse Ozlem Mete, M Sinan Dai] Führt eine Cortison-Therapie zu einer längeren Erholung und einem Anstieg der Gesamtbilirubin-Werte bei einer Patientin mit thrombotischer thrombozytopenischer Purpura und ADAMTS-13-Defizienz? Summary: A 41-year-old female patient complaining of fatigue, headache, mild confusion, and rush on her lower extremities was admitted to our emergency department. Laboratory tests revealed that he had anemia, thrombocytopenia, and increased levels of indirect bilirubin and lactic dehydrogenase (LDH) in blood tests. Direct and indirect Coombs tests were negative, and fragmented erythrocytes were observed in peripheral blood smears. The patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). The best supportive care was provided. Therapeutic plasma exchange (TPE) and 1mg/kg methylprednisolone treatments were administered. On the 10th day of treatment, LDH level and fragmented red blood cells in peripheral blood smear were decreased, but his direct and indirect bilirubin levels increased despite the fact that he was treated with 1mg/kg methylprednisolone and TPE. The patient had severe ADAMTS-13 deficiency. After discontinued steroids treatment, his bilirubin level normalized within 4 days. On the 4th day after bilirubin level normalized, vincristine treatment was administered. TPE was also continued. There was no consensus about the optimal schedule for discontinuing plasmapheresis therapy, and also we observed total bilirubin level improvement with discontinued corticosteroid treatment. In this case, corticosteroid treatment was linked with the increase of total bilirubin level in severe ADAMTS-13-deficient TTP patient. Springer-Verlag Wien, 2014 TTP nationallicence Hemolysis nationallicence TPE nationallicence Corticosteroid treatment nationallicence Severe ADAMTS-13 deficiency nationallicence Thrombotische thrombozytopenische Purpura (TTP) nationallicence Cortisonbehandlung nationallicence Schwere ADAMTS-13 Defizienz nationallicence Sayiner Zeynel Abidin Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey aut Acik Didar Yanardag Department of Haematology, Gaziantep University School of Medicine, Gaziantep, Turkey aut Yilmaz Mehmet Department of Haematology, Gaziantep University School of Medicine, Gaziantep, Turkey aut Subari Salih Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey aut Mete Ayse Ozlem Department of Infection Diseases, Gaziantep University School of Medicine, Gaziantep, Turkey aut Dai M Sinan Department of Haematology, Dicle University School of Medicine Diyarbakir, Diyarbakir, Turkey aut Wiener klinische Wochenschrift Springer Vienna 127/19-20(2015-10-01), 795-798 0043-5325 127:19-20<795 2015 127 508 https://doi.org/10.1007/s00508-014-0691-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-014-0691-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sayiner Zeynel Abidin Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey aut NATIONALLICENCE 700 1- Acik Didar Yanardag Department of Haematology, Gaziantep University School of Medicine, Gaziantep, Turkey aut NATIONALLICENCE 700 1- Yilmaz Mehmet Department of Haematology, Gaziantep University School of Medicine, Gaziantep, Turkey aut NATIONALLICENCE 700 1- Subari Salih Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey aut NATIONALLICENCE 700 1- Mete Ayse Ozlem Department of Infection Diseases, Gaziantep University School of Medicine, Gaziantep, Turkey aut NATIONALLICENCE 700 1- Dai M Sinan Department of Haematology, Dicle University School of Medicine Diyarbakir, Diyarbakir, Turkey aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/19-20(2015-10-01), 795-798 0043-5325 127:19-20<795 2015 127 508