Thrombocytopenia-Associated Multiple Organ Failure - 13/03/20

Doi : 10.1016/j.ccc.2019.12.010

Trung C. Nguyen, MD ^a,^b,^⁎
^a Department of Pediatrics, Critical Care Medicine Section, Texas Children’s Hospital/Baylor College of Medicine, 6651 Main Street, MC: E 1420, Houston, TX 77030, USA
^b The Center for Translational Research on Inflammatory Diseases (CTRID), The Michael E. DeBakey Veteran Administration Medical Center, Houston, TX 77030, USA

^∗Department of Pediatrics, Critical Care Medicine Section, Texas Children’s Hospital/Baylor College of Medicine, 6651 Main Street, MC: E 1420, Houston, TX 77030.Department of PediatricsCritical Care Medicine SectionTexas Children’s Hospital/Baylor College of Medicine6651 Main StreetMC: E 1420HoustonTX77030

Résumé

Thrombocytopenia-associated multiple organ failure is a clinical phenotype encompassing a spectrum of syndromes associated with disseminated microvascular thromboses. Autopsies performed in patients that died with thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, or disseminated intravascular coagulation reveal specific findings that can differentiate these 3 entities. Significant advancements have been made in our understanding of the pathologic mechanisms of these syndromes. Von Willebrand factor and ADAMTS-13 play a central role in thrombotic thrombocytopenic purpura. Shiga toxins and the complement pathway drive the hemolytic uremic syndrome pathology. Tissue factor activity is vital in the development of disseminated intravascular coagulation.

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Keywords : TAMOF, TTP, HUS, DIC, Platelet, Thrombocytopenia, Shiga toxin, Plasma exchange