ArticleInternational medical case reports journal2026
Refractory Acquired Thrombotic Thrombocytopenic Purpura in the Third Trimester of Twin Pregnancy: A Case Report.
Article in International medical case reports journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acquired thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening condition triggered by pregnancy, often in the third trimester, and frequently mimics preeclampsia or HELLP syndrome due to shared features like thrombocytopenia. Refractory cases in twin pregnancies, described in this case, pose unique diagnostic and therapeutic challenges, requiring advanced interventions. Case Presentation: A 29-year-old woman carrying dichorionic-diamniotic twins presented in the third trimester with palpitations, dyspnea, oral bleeding, numbness, chest heaviness, fatigue, edema, and pelvic pain. Admission showed severe thrombocytopenia (8 × 10 Conclusions: High suspicion for TTP is essential in pregnant patients with thrombocytopenia and hemolysis, even without hypertension. Rapid ADAMTS13 testing, timely delivery, and combined plasma exchange with rituximab and caplacizumab enabled full recovery in this refractory twin-pregnancy case. Multidisciplinary care is critical to differentiate from obstetric mimics and achieve favorable outcomes.
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