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Seasonal Flu as a Triggering Factor for Acquired Thrombotic Thrombocytopenic Purpura

Joseph A, Fangio P, Barbier C, Hayon J, Loubières Y, et al.

A 47 years old woman was admitted to our intensive care unit for acute asthma. An infection by influenza virus A was diagnosed and the patient presented during her hospitalization signs of thrombotic microangiopathy. Biologic analysis showed low A Desintegrin and Metalloproteinase with ThromboSpondin 1 - motifs - member 13 (ADAMTS13) activity and positive anti-A Desintegrin And Metalloproteinase with ThromboSpondin 1 - motifs - member 13 antibodies. Diagnosis of Acquired Thrombotic Thrombocytopenic Purpura was considered and a specific treatment was started with plasma exchange and intravenous administration of rituximab for relapse. Acquired Thrombotic Thrombocytopenic Purpura is considered an auto-immune disease. As such, it can be triggered by bacterial or viral infection. Many triggering factors have been described. Testing for influenza virus should be considered in epidemic situations when a Thrombotic Thrombocytopenic Purpura is diagnosed.