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 Table of Contents  
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
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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 2023 Mar 25];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.

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There are no conflicts of interest.

  References Top

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]  
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
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
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
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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