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Journal of Obstrectic Anaesthesia and Critical Care
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LETTER TO EDITOR
Year : 2020  |  Volume : 10  |  Issue : 1  |  Page : 63-64

Thrombotic thrombocytopenic purpura during pregnancy


1 Departmen of Medical Sciences, University of Torino, Corso AM Dogliotti 14, Torino, Italy
2 Department of Biotechnology Chemistry and Pharmacy University of Siena, Via A. Moro, Siena, Italy

Date of Submission20-Sep-2019
Date of Acceptance25-Oct-2019
Date of Web Publication11-Mar-2020

Correspondence Address:
Dr. Antonio Ponzetto
Department of Medical Sciences, University of Torino, Corso AM Dogliotti 14, Torino -10126
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacc.JOACC_43_19

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How to cite this article:
Ponzetto A, Figura N. Thrombotic thrombocytopenic purpura during pregnancy. J Obstet Anaesth Crit Care 2020;10:63-4

How to cite this URL:
Ponzetto A, Figura N. Thrombotic thrombocytopenic purpura during pregnancy. J Obstet Anaesth Crit Care [serial online] 2020 [cited 2020 Nov 26];10:63-4. Available from: https://www.joacc.com/text.asp?2020/10/1/63/280362



Dear Sir,

We found of interest the clinical case of thrombotic thrombocytopenic purpura (TTP) during pregnancy presented by Basta.[1] He reports of a 39-year-old lady who had had previous episodes of TTP correlated with pregnancy; therefore, a presumptive diagnosis of acquired TTP was made. We would like to stress the correlation between TTP and infection by Helicobacter pylori, in particular when it belongs to the so-called pathogenic strain, which is characterized by the synthesis of the cytotoxin-associated gene A protein (CagA).[2] The cure of this bacterium was followed by regression of TTP.[3] In the case reported by Basta, the lady's previous pregnancy was complicated by pre-eclampsia (PE), another ailment strongly associated with infection by Helicobacter pylori: we observed that in Turin, Italy, 90.6% of preeclamptic women giving birth to small-for-gestational age newborns were infected by CagA positive strains of the bacterium, compared to 22.4% of uneventful pregnancies (odds ratio, 17.66).[4] Several other reports confirmed our findings.[5] We believe that the prudent physician should search for the infection by pathogenic strains of H. pylori prior to every pregnancy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Basta M. Thrombotic thrombocytopenic purpura during pregnancy and its overlap with the HELLP syndrome, a clinical dilemma: A case report and review of the literature. J Obstet Anaesth Crit Care 2019;9:50-2.  Back to cited text no. 1
  [Full text]  
2.
Takahashi T, Yujiri T, Shinohara K, Inoue Y, Sato Y, Fujii Y, et al. Molecular mimicry by Helicobacter pylori CagA protein may be involved in the pathogenesis of H. pylori-associated chronic idiopathic thrombocytopenic purpura. Br J Haematol 2004;124:91-6.  Back to cited text no. 2
    
3.
Hino M, Yamane T, Park K, Takubo T, Ohta K, Kitagawa S, et al. Platelet recovery after eradication of Helicobacter pylori in patients with idiopathic thrombocytopenic purpura. Ann Hematol 2003;82:30-2.  Back to cited text no. 3
    
4.
Cardaropoli S, Rolfo A, Piazzese A, Ponzetto A, Todros T. Helicobacter pylori's virulence and infection persistence define pre-eclampsia complicated by fetal growth retardation. World J Gastroenterol 2011;17:5156-65.  Back to cited text no. 4
    
5.
Nourollahpour Shiadeh M, Riahi SM, Adam I, Saber V, Behboodi Moghadam Z, Armon B, et al. Helicobacter pylori infection and risk of preeclampsia: A systematic review and meta-analysis. J. Materno-Fetal Neonatal Med 2019;32:324-31.  Back to cited text no. 5
    




 

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