Severe Plasmodium falciparum malaria with marked ADAMTS13 reduction and secondary microangiopathic features: A case report.
Ming Huang, Xishuai Jia, Xiaomei Wang et al.
✦ AI-curated · Sources linked
Case in brief
A 46-year-old man returning from Nigeria presented with severe Plasmodium falciparum malaria after 11 days of intermittent fever, jaundice, and dark urine. Laboratory findings indicated severe anemia, thrombocytopenia, and acute kidney injury, with a peripheral blood smear showing high parasitemia. The patient developed multi-organ dysfunction and marked ADAMTS13 reduction. Following treatment with intravenous artesunate and supportive care, he improved significantly, with increased ADAMTS13 activity.
What made this case unusual
The case highlights the diagnostic challenge of distinguishing malaria-associated microangiopathic changes from primary TTP-spectrum disorders due to the marked reduction in ADAMTS13 activity.
Diagnostic / clinical pearl
Clinicians should consider the potential for severe malaria to cause microangiopathic features and reduced ADAMTS13 activity, which may mimic TTP-spectrum disorders.
Why it matters
Recognizing the overlap between malaria and TTP-spectrum disorders can facilitate timely diagnosis and appropriate management, improving patient outcomes.