Table 2 Case reports of concomitant thrombotic microangiopathy and diabetic ketoacidosis
Age | Sex | Initial presentation | Lab before TPE/FFP | ADAMTS-13 activity | Treatment for TMA | Outcome | |
|---|---|---|---|---|---|---|---|
Confirmed TTP | |||||||
Jackson et al. 2021 [20] | 62 | male | Generalized abdominal pain, thirst, and fatigue for several days | Hb: 7.5 PLT: 18 LDH: > 2800 BUN: 78 CRE: 2.4 | < 1 | Steroid FFP TPE Rituximab | Improved and survived |
TMA with high ADAMTS-13 activity | |||||||
Patra et al. 2011 [11] | 12 | female | Irritability and drowsiness for one day | Hb: 10.6 PLT: 29 LDH: 1349 BUN: 61 CRE: 2.2 | 52 | TPE | Improved and survived |
Alsaied et al. 2016 [14] | 18 | female | Respiratory distress few hours | Hb: 8.8 PLT: 32 LDH: >4000 CRE: 4.4 | 31 | CRRT TPE | Improved and survived with left side weakness |
Kumar et al. 2016 [15] | 1 | female | Vomiting for two days | Hb: 7.7 PLT: 20 LDH: 743 BUN: 67.5 CRE: 1.98 | 34 | FFP TPE | Improved and survived |
Hermelin et al. 2019 [19] | 34 | female | General weakness and blurred vision | Hb: 9.6 PLT: 33 LDH: 2130 CRE: 2.6 | 40.7 | TPE | Improved and survived with blindness |
Nwankwo et al. 2023 [21] | 45 | male | Severe abdominal pain, vomiting, and altered sensorium for one day Seizure | Hb: 8.5 PLT: 51 LDH: 588 CRE: 2.2 | 21 | Steroid TPE Rituximab | Expired |
TMA with unknown ADAMTS-13 activity | |||||||
Khan et al. 2013 [12] | 14 | female | Fever, vomiting, respiratory distress and LOC for one day | Hb: 7.0 PLT: 42 LDH: 1223 BUN: 75 CRE: 4.4 | NA | CRRT TPE | Improved and survived |
13 | female | Vomiting and LOC few hours | Hb: 8.7 PLT: 45 LDH: 1439 BUN: 39 CRE: 3.5 | NA | CRRT TPE | Improved and survived | |
Merrick et al. 2014 [13] | 9 | female | LOC | PLT: 31 Deteriorating renal function | NA | TPE | Improved and survived |
Mostofizadeh et al. 2018 [16] | 6 | female | Respiratory distress, seizure and deep coma | Hb: 8.9 PLT: 62 LDH: 1455 BUN: 60 CRE: 2.7 | NA | TPE | Improved and survived |
Meenakshi et al. 2020 [17] | 11 | male | Vomiting and abdominal pain for five days | Hb: 10.5 PLT: 16 LDH: 1179 BUN: 125 CRE: 2.7 | NA | FFP | Improved and survived |
Ponnambalam et al. 2020 [18] | 2 | male | Fever and breathlessness for 3 days | Hb: 6.2 PLT: 52 LDH: 1133 BUN: 52 CRE: 0.8 | NA | FFP | Improved and survived Developmental regression (motor, language) |