Immune thrombocytopenia and thrombotic microangiopathy in pregnancy:key strategies for clinical differentiation
TANG Ping-ping
GAO Jin-song
Abstract：Thrombocytopenia is a common hematologic complication during pregnancy,and immune thrombocyto-penia and thrombotic microangiopathy(TMA)are rare but important etiologies,requiring precise differentiation due to their distinct pathological mechanisms,treatment strate-gies,and maternal-fetal risks.Immune thrombocytopenia refers to thrombocytopenia mediated by abnormal immune activation.The diagnosis of primary immune thrombocyto-penia(ITP)should exclude secondary ITP due to other causes(such as autoimmune diseases,infections,drugs,tumors,etc.),and the treatment for ITP primarily involves glucocorticoids and intravenous immunoglobulin.TMA is a group of heterogeneous diseases with the core pathological features of microvascular thrombosis,presenting with mi-croangiopathic hemolysis,thrombocytopenia,and multi-or-gan dysfunction,which requires specific interventions based on different disease types,such as pregnancy termi-nation,plasma exchange,or complement inhibitors.This ar-ticle systematically outlines the key points for differential diagnosis of ITP and TMA based on clinical features,labo-ratory tests and molecular markers,emphasizing the criti-cal importance of initiating targeted therapy promptly in im-proving maternal-fetal prognosis.
Keywords：immune thrombocytopeniathrombotic microangiopathypregnancy complicationsdifferential diagnosis
Publication Date：2025-09-02
Online Publishing Date：2025-10-20(First online date of this platform, not the publication date of the document)
Pages：5( 890-894 )