Kaloterakis A, Filiotou A, Kolnagou J, Procopiou C, Karvoutzis G, Hadjiyannis S; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: 93 (abstract no. PuB 7269).
Hippocration Hospital, University of Athens, Greece.
Seventeen cases of Thrombotic Thrombocytopenic Purpura (TTP), associated with HIV infection have been reported in the world literature. HIV associated TTP has been treated with Zidovudine (ZDV) in only one case, after multiple relapses. Recently, a 36 year old Greek woman, was admitted with a 3 days history of fever, bleeding diathesis, headache, altered mental status. Physical examination: Fever, jaundice, purpura, gingival-vaginal bleeding, herpes zoster rash on left hemithorax, mouth membranes candidiasis, hairy leukoplakia, deep coma. Laboratory data: Ht 20%, platelets 18.000/mm3, Reticulocytes 8%. Blood smear: schistocytosis, nucleated red cells, polychromasia. BUN 55mg%, creatinine 2.3mg%, bilirubin 8.4mg%, LDH 3600 U/L, prothrombin time 14sec, cephotest 35sec, FDP greater than 2 micrograms/ml, fibrinogen 340mg%, HIV ab's ELIZA positive, confirmed positive by Western-blot. CD4 168/mm3, CD8 279/mm3, CD4/CD8 0.6. Complete remission was achieved after treatment with: Fresh Frozen Plasma (FFP), Packed red cells, Methyl-Prednisolone (MP) 1gr IV, days 1-3, Vincristine (VCR) 2mg IV, days 1 and 5, Zidovudine 2tb (200mg) x 6, through a nasogastric catheter/day, Acyclovir 400mg x 4 IV/day, Fungustatin 100mg/day. The patient remains in complete remission, 4 months after the episode of ARC associated TTP, taking ZVD 100mg po x 5/day and TMP-SMT x 3 days/week. CONCLUSIONS: TTP is a rare disorder of unknown cause and it is also a newly recognized manifestation of HIV infection. Therefore TTP should be considered in patients with HIV infection with thrombocytopenia and inversely, HIV infection should be considered in patients with TTP as was the case in our patient. It seems that our patient's recovery was due to the aggressive treatment with FFP, MP, VCR and ZDV. We think that ZDV could be the cornerstone of therapeutic success in HIV related TTP.
Publication Types:
Keywords:
- AIDS Vaccines
- AIDS-Related Complex
- Acquired Immunodeficiency Syndrome
- Antigens, CD4
- Female
- HIV Infections
- HIV Seropositivity
- Hemorrhage
- Humans
- Leukoplakia, Hairy
- Purpura, Thrombotic Thrombocytopenic
- Uterine Hemorrhage
- Vincristine
- Zidovudine
- immunology
Other ID:
UI: 102202267
From Meeting Abstracts