Advances in the pathogenesis, diagnosis and treatment of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome

被引:26
作者
Franchini, Massimo
Zaffanello, Marco
Veneri, Dino
机构
[1] Osped Policlin, Serv Immunoematol & Trasfus, I-37134 Verona, Italy
[2] Univ Verona, Pediat Clin, I-37100 Verona, Italy
[3] Univ Verona, Dipartimento Med Sperimentale & Clin, Div Ematol, I-37100 Verona, Italy
关键词
D O I
10.1016/j.thromres.2005.07.013
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The thrombotic microangiopathies are microvascular occlusive disorders characterized by hemolytic anemia caused by fragmentation of erythrocytes and thrombocytopenia due to increased platelet aggregation and thrombus formation, eventually leading to disturbed microcirculation with reduced organ perfusion. Depending on whether brain or renal lesions prevail, two different entities have been described: thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). However, not rarely the clinical distinctions between these two conditions remain questionable. Recent studies have contributed greatly to our current understanding of the molecular mechanisms leading to TTP and HUS. In this review, we briefly focus on the most important advances in the pathophysiology, diagnosis and treatment of these two thrombotic microangiopathies. (c) 2005 Elsevier Ltd. All rights reserved.
引用
收藏
页码:177 / 184
页数:8
相关论文
共 100 条
[21]   Partial purification and characterization of a protease from human plasma cleaving von Willebrand factor to fragments produced by in vivo proteolysis [J].
Furlan, M ;
Robles, R ;
Lammle, B .
BLOOD, 1996, 87 (10) :4223-4234
[22]   Aetiology and pathogenesis of thrombotic thrombocytopenic purpura and haemolytic uraemic syndrome:: the role of von Willebrand factor-cleaving protease [J].
Furlan, M ;
Lämmle, B .
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY, 2001, 14 (02) :437-454
[23]  
GASSER C, 1955, Schweiz Med Wochenschr, V85, P905
[24]   Partial amino acid sequence of purified von Willebrand factor-cleaving protease [J].
Gerritsen, HE ;
Robles, R ;
Lämmle, B ;
Furlan, M .
BLOOD, 2001, 98 (06) :1654-1661
[25]   ESCHERICHIA-COLI O157-H7-ASSOCIATED COLITIS - A CLINICAL AND HISTOLOGICAL STUDY OF 11 CASES [J].
GRIFFIN, PM ;
OLMSTEAD, LC ;
PETRAS, RE .
GASTROENTEROLOGY, 1990, 99 (01) :142-149
[26]   ILLNESSES ASSOCIATED WITH ESCHERICHIA-COLI O157-H7 INFECTIONS - A BROAD CLINICAL SPECTRUM [J].
GRIFFIN, PM ;
OSTROFF, SM ;
TAUXE, RV ;
GREENE, KD ;
WELLS, JG ;
LEWIS, JH ;
BLAKE, PA .
ANNALS OF INTERNAL MEDICINE, 1988, 109 (09) :705-712
[27]   TREATMENT OF THROMBOTIC THROMBOCYTOPENIC PURPURA WITH VINCRISTINE [J].
GUTTERMAN, LA ;
STEVENSON, TD .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1982, 247 (10) :1433-1436
[28]   TREATMENT OUTCOMES IN PATIENTS WITH ADULT THROMBOTIC THROMBOCYTOPENIC PURPURA HEMOLYTIC-UREMIC SYNDROME [J].
HAYWARD, CPM ;
SUTTON, DMC ;
CARTER, WH ;
CAMPBELL, ED ;
SCOTT, JG ;
FRANCOMBE, WH ;
SHUMAK, KH ;
BAKER, MA .
ARCHIVES OF INTERNAL MEDICINE, 1994, 154 (09) :982-987
[29]  
HENON P, 1991, PRESSE MED, V20, P1761
[30]  
Hovinga JAK, 2004, HAEMATOLOGICA, V89, P320