Abstract:
:Thrombotic microangiopathy (TMA) is a recognized complication of malignant hypertension (HTN). Such patients have blood pressures > or = 200/140 mmHg but the condition is defined by the presence of papilledema and is frequently complicated by acute renal failure. Here we report two patients with severe HTN (systolic > or = 180 mmHg or diastolic > or = 120 mmHg), TMA, thrombocytopenia, renal failure, and, in one case, neurological changes (4 of 5 manifestations of the TTP pentad). A 50-year-old male with HTN presented with blurred vision, dizziness, headache, confusion, renal failure, and a TMA (PLT = 39 x 10(9)/L and LD = 2,781 normal <600 U/L). On presentation, BP was 214/133 mmHg and an ophthalmic exam demonstrated no papilledema. With HTN control over 7 days, his platelet count rebounded (220 x 10(9)/L), LD declined (1,730 U/L), and mental status improved. A 60-year-old female with diabetes, HTN, Lupus erythematosus, mild chronic anemia, and thrombocytopenia presented with abdominal pain, shortness of breath, renal failure, and a TMA (PLT = 83 x 10(9)/L and LD = 2,929 U/L). Blood pressures were 180-210/89-111 mmHg and ophthalmic exam demonstrated no papilledema. With HTN control over 8 days, her platelet count rebounded (147 x 10(9)/L), and LD declined (1,624 U/L). Although in both cases a diagnosis of TTP was considered because of overlap with the classic diagnostic pentad, neither received plasmapheresis. TTP is a diagnosis of exclusion, where there is no other likely diagnosis to explain the TMA. In cases of severe HTN (with or without papilledema), the diagnosis of TTP should be held in abeyance until the effect of HTN control can be assessed.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Egan JA,Bandarenko N,Hay SN,Paradowski L,Goldberg R,Nickeleit V,Brecher MEdoi
10.1002/jca.20016subject
Has Abstractpub_date
2004-01-01 00:00:00pages
125-9issue
3eissn
0733-2459issn
1098-1101journal_volume
19pub_type
杂志文章abstract::Prestorage leukocyte reduction of platelet concentrates may reduce adverse effects of transfusion while affording better quality control. Platelets and leukocytes may undergo activation during storage, which could affect the performance of leukocyte reduction filters. The purpose of this study was to evaluate the effi...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1997)12:1<14::aid-jca4>3.0
更新日期:1997-01-01 00:00:00
abstract::Either bone marrow or peripheral blood may be harvested to provide hematopoietic stem cells (HSC) for autologous transplantation. Both, however, comprise heterogeneous cell populations. The HSC necessary for successful engraftment constitute a very small fraction of the cells harvested. After collection, the harvested...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.2920070307
更新日期:1992-01-01 00:00:00
abstract::Granulocyte-colony stimulating factor (G-CSF) mobilizes and increases the amount of hematopoietic stem cells in peripheral blood, enabling its harvest by few apheresis procedures. The pegylated G-CSF has longer half-life and is given once only, which is more comfortable for patients, whereas the non-pegylated requires...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,meta分析,评审
doi:10.1002/jca.21550
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Myeloid-derived leucocytes, a major source of inflammatory cytokines, play an important role in the exacerbation of ulcerative colitis (UC). Selective depletion of myeloid leucocytes by adsorptive granulomonocytapheresis (GMA) with an Adacolumn should alleviate inflammation and promote remission. However, th...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21787
更新日期:2020-08-01 00:00:00
abstract::Plasma replacement for thrombotic thrombocytopenic purpura (TTP) is accomplished with various plasma products. This study sought to determine the incidence of allergic reactions with FFP or CPP as replacement in therapeutic plasma exchange (TPE). Forty-one TTP patients were identified retrospectively who received TPE ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.1025
更新日期:2001-01-01 00:00:00
abstract::Targeted extracorporeal granulocyte and monocyte apheresis (GMA) has produced clinical efficacy together with down modulation of specific inflammatory cytokines in patients with ulcerative colitis (UC). This study was to investigate if preoperative GMA produces immunological effect on dysregulated immune activity afte...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,随机对照试验
doi:10.1002/jca.21299
更新日期:2014-04-01 00:00:00
abstract::Acute thrombotic thrombocytopenic purpura (TTP) occurred in three patients following abdominal surgeries. One patient underwent extensive lysis for intestinal adhesions with bowel resection, another cholecystectomy for acute cholecystitis, and the third right colectomy and partial intestinal resection for colon cancer...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/1098-1101(2000)15:3<176::aid-jca4>3.0.co;2
更新日期:2000-01-01 00:00:00
abstract::In December 2007, the FDA issued a guidance document recommending that apheresis cell separators be configured with a postdonation platelet count target of > or =100,000 platelets/microL. Currently, our Trima Accel apheresis cell separators are configured with a postdonation platelet count target of > or =50,000 plate...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20214
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Plasma exchange (PE) and double filtration plasmapheresis (DFPP) are known as effective treatment options for hyperviscosity syndrome (HVS) caused by Waldenstrom macroglobulinemia. Nonetheless, few data are available for the relation between the prescribed dose of apheresis and the reduction rate of target m...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21655
更新日期:2018-10-01 00:00:00
abstract::Because the administration of hematopoietic growth factors and the use of stem cell support often fails to alleviate the neutropenic phase induced by cytotoxic drugs, several investigators have attempted to expand ex vivo hematopoietic progenitors for clinical use. These attempts have clearly shown that the cultured c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10012
更新日期:2002-01-01 00:00:00
abstract::Blood group incompatibility remains a significant barrier to kidney transplantation. Approximately, one-third of donors are blood group incompatible with their intended recipient. Options for these donor-recipient pairs include blood group incompatible transplantation or kidney paired donation. However, the optimal pr...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21390
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The ability to cryopreserve a portion of the cells treated during extracorporeal photopheresis (ECP) would improve therapy logistics, particularly for pediatric patients, by allowing multiple therapeutic doses to be collected from a single apheresis session. However, the effect of cryopreservation on ECP-tre...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21354
更新日期:2015-06-01 00:00:00
abstract::Focal segmental glomerulosclerosis (FSGS) recurs in 30% of renal allograft transplants with graft loss in half of the cases. A humoral factor may be implicated. We report on the use of therapeutic plasma exchange (TPE) in 11 patients with recurrent FSGS post transplantation. Medical records from 1989-2000 were reviewe...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10025
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Securing adequate vascular access is essential for a successful apheresis procedure. In most, peripheral access is preferred but it is not always technically possible. Ultrasound-Guided Peripheral Vascular Access (USG-PIVA) is a well-documented technique in the setting of Emergency departments. However, limi...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21440
更新日期:2016-12-01 00:00:00
abstract::Over the past 37 year the role of plasma exchange in the treatment of patients with renal disease has undergone several changes. The majority of the changes for the use of plasma exchange relied on randomized control trials and delineations of mechanisms that potentially would benefit from the use of plasma exchange. ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21221
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:In organ transplantation, apheresis is frequently used for removal of anti-HLA antibodies. However, it is unclear whether plasmapheresis (PP) or semi-selective immunoadsorption (IA) should be employed, and the optimal number of apheresis sessions required to reach post-treatment objectives is also unknown. ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21858
更新日期:2020-11-30 00:00:00
abstract::Graphite furnace atomic absorption spectroscopy was used to demonstrate a fivefold increase in the median plasma aluminium levels of four patients undergoing therapeutic plasmapheresis. This plasma aluminium loading resulted from contamination of albumin incorporated in the replacement fluids and took place during its...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920030306
更新日期:1987-01-01 00:00:00
abstract::Extracorporeal photopheresis (ECP) in young pediatric patients has a risk for procedural hypotension and anemia due to extracorporeal fluid shifts. A standard mitigation policy in these patients is to prime the device with packed red blood cells (RBC) or whole blood. We now report multiple episodes of hemolysis while ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21740
更新日期:2019-12-01 00:00:00
abstract::Extracorporeal photopheresis (ECP) has been shown to be clinically effective in the treatment of many T cell-mediated conditions. ECP's mechanism of action includes the induction of apoptosis and the release of pro-inflammatory cytokines. Recently, we have observed early lymphoid apoptosis, detectable immediately post...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10039
更新日期:2002-01-01 00:00:00
abstract::Complement-derived anaphylatoxin may be one of the causes of vascular injury and an indicator of activity in systemic lupus erythematosus (SLE). The present study examines the effectiveness of dextran sulfate (DS) column immunoadsorption treatment to remove anaphylatoxins (C3a, C4a, and C5a) from the blood of patients...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1998)13:3<108::aid-jca3>3.
更新日期:1998-01-01 00:00:00
abstract::Heparin-induced thrombocytopenia (HIT) can occur following exposure to heparin and is characterized by thrombocytopenia with increased risk for thrombosis. This condition is mediated by formation of immunoglobulin G antibodies against platelet factor 4/heparin complexes that can subsequently lead to platelet activatio...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
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更新日期:2020-01-01 00:00:00
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journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21650
更新日期:2018-10-01 00:00:00
abstract::Until recently, the collection of peripheral blood progenitor cells (PBPC) has been semi-automated by using the COBE Spectra, with the operator manually maintaining the position of the white cells being collected. The COBE Spectra Version 6.0 apheresis device offers the user an automated program for the collection of ...
journal_title:Journal of clinical apheresis
pub_type: 临床试验,杂志文章
doi:10.1002/(sici)1098-1101(1999)14:1<26::aid-jca5>3.0
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:Effects of therapeutic plasma exchange (TPE) on immune cells and their cytokine production in MS, are unknown. Since interleukine-6 and tumor growth factor-β have critical roles in MS immunopathogenesis, the impacts of TPE on the expression of these cytokines and their receptors on the surface of CD4+ T lymph...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21755
更新日期:2020-04-01 00:00:00
abstract::One of the most serious problems in applying leukapheresis to human infants is the large extracorporeal blood volume (ECV), resulting in substantial loss of platelets and red blood cells (RBCs). In this study, we developed a safe and effective modified procedure to collect peripheral blood stem cells (PBSCs) from rhes...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10043
更新日期:2003-01-01 00:00:00
abstract::This is an attempt at comparing two cell separators for plateletpheresis, namely the Fresenius AS.TEC 204 and Haemonetics MCS 3p, at a tertiary care center in India. Donors who weighed between 55-75 kg, who had a hematocrit of 41-43%, and platelet counts of 250x10(3)-400x10(3)/microl were selected for the study. The c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20108
更新日期:2007-02-01 00:00:00
abstract::Two patients suffering from allergic bronchial asthma who showed no improvement despite six and four weeks, respectively, of drug therapy were successfully treated with therapeutic plasma exchange. The first patient had no attacks over a period of five months, and the other patient had none for over one year. Although...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920020210
更新日期:1984-01-01 00:00:00
abstract::Thrombotic thrombocytopenic purpura (TTP) is a rare but severe disorder characterized by hemolytic anemia, thrombocytopenia, fever, renal failure, and neurologic manifestations. Plasma exchange is the most effective treatment for this condition reducing mortality from 90% in untreated patients to 10%. However, infecti...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20119
更新日期:2007-01-01 00:00:00
abstract::Photopheresis has become a key component in the therapeutic armamentarium of cutaneous T-cell lymphoma, graft-versus-host disease following stem cell transplant, and allograft rejection of solid organs such as heart. Although it is considered a new treatment modality in its present form, the field of phototherapy date...
journal_title:Journal of clinical apheresis
pub_type: 历史文章,杂志文章,评审
doi:10.1002/jca.20089
更新日期:2006-04-01 00:00:00
abstract::The process of publishing original work in a peer review journal is not complete at the point where the manuscript is first submitted. The journal editors will submit the manuscript to peer review whereby outside experts are asked to vet the manuscript for scientific merit, originality and quality. Reviewers' comments...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21822
更新日期:2020-08-07 00:00:00