Reversible skin microvascular hyporeactivity in patients with immune-mediated thrombocytopenic thrombotic purpura
Authors' conclusion
We highlighted a marked yet reversible skin endothelium-mediated microvascular hyporeactivity in iTTP patients that could participate in organ injury pathophysiology.
Study context
- Population
- Adults (> 18-year old) admitted in ICU for iTTP
- Exposure
- iTTP patients vs controls; iTTP at admission vs after PE
- iTTPn = Eighteen
- Controlsn = 34reference
- Outcome
- Endothelial-mediated skin microvascular vasoreactivity (laser Doppler flowmetry with acetylcholine iontophoresis, forearm)
- Follow-up
- At admission and after PE
Methodological detailspilot, historical control cohort
- Pilot
- Historical control cohort
Main finding
As reported in the abstract
Baseline microvascular blood flow, iTTP vs controls (PU)
5.97 ± 4.5 vs. 10.1 ± 6.3 PU
P = 0.03
Endothelial-mediated skin microvascular reactivity (AUC), iTTP vs controls
9627 ± 8122 vs. 16,475 ± 11,738
P = 0.03
Microvascular reactivity (AUC), baseline vs post-PE1
9627 ± 8122 vs 16,558 ± 10,699
P = 0.007
Microvascular reactivity (AUC) post-PE2, vs post-PE1
26,431 ± 23,181
P = 0.04
Observational data: associations, not effects.
Further findings
Hemolysis biomarkers (LDH and bilirubin)
- Negatively correlated with skin microvascular flow and vasoreactivity
Clinical features at admission (iTTP)
- Neurological abnormalities
- 55%
- Cardiac issues
- 50%
- AKI
- 27.8%
- Median platelet count
- 19 G/mL [10-37]
Original publication
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