Autopsy case of sudden maternal death from thrombotic thrombocytopenic purpura

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

Research output: Contribution to journalArticle

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
Externally publishedYes

Fingerprint

Thrombotic Thrombocytopenic Purpura
Maternal Death
Sudden Death
Autopsy
Thrombospondins
Disintegrins
Pregnancy
von Willebrand Factor
Metalloproteases
Heart Arrest
Abdominal Pain
Hospital Emergency Service
Pregnant Women
Japan
Thrombosis
Differential Diagnosis
Fever
Staining and Labeling
Lung
Therapeutics

Keywords

  • ADAMTS13
  • Maternal death
  • Pregnancy
  • Thrombotic thrombocytopenic purpura

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Autopsy case of sudden maternal death from thrombotic thrombocytopenic purpura. / Yamamoto, Takuma; Fujimura, Yoshihiro; Emoto, Yuko; Kuriu, Yukiko; Iino, Morio; Matoba, Ryoji.

In: Journal of Obstetrics and Gynaecology Research, Vol. 39, No. 1, 01.2013, p. 351-354.

Research output: Contribution to journalArticle

Yamamoto, Takuma ; Fujimura, Yoshihiro ; Emoto, Yuko ; Kuriu, Yukiko ; Iino, Morio ; Matoba, Ryoji. / Autopsy case of sudden maternal death from thrombotic thrombocytopenic purpura. In: Journal of Obstetrics and Gynaecology Research. 2013 ; Vol. 39, No. 1. pp. 351-354.
@article{f63899557af44338afb50c6599289409,
title = "Autopsy case of sudden maternal death from thrombotic thrombocytopenic purpura",
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.",
keywords = "ADAMTS13, Maternal death, Pregnancy, Thrombotic thrombocytopenic purpura",
author = "Takuma Yamamoto and Yoshihiro Fujimura and Yuko Emoto and Yukiko Kuriu and Morio Iino and Ryoji Matoba",
year = "2013",
month = "1",
doi = "10.1111/j.1447-0756.2012.01941.x",
language = "English",
volume = "39",
pages = "351--354",
journal = "Asia-Oceania Journal of Obstetrics and Gynaecology",
issn = "1341-8076",
publisher = "Blackwell Publishing Asia",
number = "1",

}

TY - JOUR

T1 - Autopsy case of sudden maternal death from thrombotic thrombocytopenic purpura

AU - Yamamoto, Takuma

AU - Fujimura, Yoshihiro

AU - Emoto, Yuko

AU - Kuriu, Yukiko

AU - Iino, Morio

AU - Matoba, Ryoji

PY - 2013/1

Y1 - 2013/1

N2 - 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.

AB - 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.

KW - ADAMTS13

KW - Maternal death

KW - Pregnancy

KW - Thrombotic thrombocytopenic purpura

UR - http://www.scopus.com/inward/record.url?scp=84875695688&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875695688&partnerID=8YFLogxK

U2 - 10.1111/j.1447-0756.2012.01941.x

DO - 10.1111/j.1447-0756.2012.01941.x

M3 - Article

C2 - 22765161

AN - SCOPUS:84875695688

VL - 39

SP - 351

EP - 354

JO - Asia-Oceania Journal of Obstetrics and Gynaecology

JF - Asia-Oceania Journal of Obstetrics and Gynaecology

SN - 1341-8076

IS - 1

ER -