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|Post 106 - By: Dr. George - Post Date: 5/20/2010|
|It is hard for me to say anything useful about this dilemma because I have no experience, except to say that I can understand the problem very clearly. This is not a diagnostic issue for us because malaria occurs very rarely in our region. I assume that in regions where malaria is endemic, such as sub-Saharan Africa, that the initial diagnosis would always be malaria, since TTP is very rare in any region, with an incidence of only 1-4 per million population per year. Also the treatment for TTP (plasma exchange) is complex, probably not readily available in most areas where malaria is endemic, and even when it is available, plasma exchange is associated with a high risk of major complications; in our experience, complications of plasma exchange caused death in 3% of patients.
ADAMTS13 assays are also not readily available anywhere in the world, and TTP can occur with normal ADAMTS13 activity and other diseases (maybe even malaria?) may be associated with low ADAMTS13 activity. So this is not a specific diagnostic test and should not be used to make the decision to treat or not to treat with plasma exchange.
I think my suggestion would be to consider plasma exchange treatment for possible TTP only in patients who fail to respond to treatment for malaria and in whom no diagnosis other than TTP is discovered.
|Post 107 - By: Wanda - Post Date: 5/18/2010|
|Hope there is a cure soon ..plasma exchange is very hard on me..thanks for your website!
|Post 108 - By: tukaram - Post Date: 5/16/2010|
severe malaria with multiorgan dysfunction is a close mimic of TMA in our setting. its not uncommon to have a negative smear by the time pt is referred to tertiary care unit. often there is a dilemma as to initiation of plasma exchange in this setting. any practical suggestions?
|Post 109 - By: Suzanne Subritzky - Post Date: 5/13/2010|
|This request is on behalf of Fe Gordon Royle, Haematologist at Middelmore Hospital, Auckland, New Zealand. He wishes to use one of your platelet images in a poster for educational purposes at the hospital ( thromboprophylaxis education). Is there a fee for this or is the service free? Thank you for your help.
|Post 110 - By: Magda El-Nokaly - Post Date: 4/23/2010|
|I want to know more about ITP relation with allergies specially mold. Also where could I find the food guidelines for ITP patients Thanks
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