Autopsy case of sudden maternal death from thrombotic thrombocytopenic purpura

Takuma Yamamoto, Yoshihiro Fujimura, Yuko Emoto, Yukiko Kuriu, Morio Iino, Ryoji Matoba

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3 Citations (Scopus)

Abstract

A 31-year-old pregnant woman was transferred to the emergency room at 27 weeks of gestation. She had one-day history of fever and upper abdominal pain. Soon after admission, she underwent cardiopulmonary arrest. Autopsy was performed and multiple microthrombi were seen within the small-caliber vessels of many organs, but not in the lungs. Immunohistochemical staining revealed that the thrombi were rich in von Willebrand factor. We also obtained results which showed severely deficient plasma a disintegrin-like and metalloprotease with thrombospondin motifs (ADAMTS) 13 activity and positive ADAMTS13 inhibitor, confirming a diagnosis of thrombotic thrombocytopenic purpura. As far as we know, in Japan, this is the first autopsy report of sudden maternal death from thrombotic thrombocytopenic purpura. We expect that the routine laboratory application of ADAMTS13 assays for unknown thrombocytopenic patients during pregnancy may help in differential diagnosis at an earlier stage of the disease and facilitate tailor-made therapeutic intervention.

Original languageEnglish
Pages (from-to)351-354
Number of pages4
JournalJournal of Obstetrics and Gynaecology Research
Volume39
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Keywords

  • ADAMTS13
  • Maternal death
  • Pregnancy
  • Thrombotic thrombocytopenic purpura

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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