В статье приведено краткое описание редкого заболевания – тромботической тромбоцитопенической пурпуры (болезни Мошковица), в основе которого лежит дефицит металлопротеиназы ADAMTS-13, приводящий к развитию тромботической микроангиопатии с поражением жизненно важных органов. Также в статье приведено описание клинического наблюдения пациента с болезнью Мошковица. Особенностями приведенного наблюдения являются вовлечение в патологический процесс почек и кишечника, тогда как в классических описаниях данного заболевания отмечается преимущественное поражение центральной нервной системы, а также генетическая форма заболевания.
The article presents a brief description of a rare disease – thrombotic thrombocytopenic purpura (Moshkovits-disease), which is based on the deficiency of ADAMTS-13 metalloproteinase, leading to the development of thrombotic microangiopathy with the defeat of vital organs. The article also describes the clinical observation of a patient with the Moshkovits-disease. The features of the above observation are involvement in the pathological process of the kidneys and intestines, while in the classical descriptions of the disease there is a predominant lesion of the Central nervous system, as well as the genetic form of the disease.
1. Joly BS, Coppo P, Veyradier A. Thrombotic thrombocytopenic purpura. Blood. 2017 May 25;129(21):2836-46 [Medline]. doi: 10.1182/blood-2016-10-709857
2. Thrombotic thrombocytopenic purpura. https://emedicine.medscape.com/ article/206598-overview#a5 ссылка активна на 04.07.2018
3. Moschcowitz E. https://en.wikipedia.org/wiki/Eli_Moschcowitz ссылка активна на 04.07.2018
4. Moake JL. Thrombotic microangiopathies. N Engl J Med. 2002;347(8):589-600. doi: 10.1056/NEJMra020528
5. Benz K, Amann K. Pathological aspects of membranoproliferative glomerulonephritis (MPGN) and haemolytic uraemic syndrome (HUS) / thrombocytic thrombopenic purpura (TTP). Thromb Haemost. 2009;101:265-70. doi: 10.1160/TH07-12-0761
6. Feng Y, Li X, Xiao J, Li W, Liu J, Zeng X, Chen X, Chen S. ADAMTS13: more than a regulator of thrombosis. Int J Hematol. 2016;104(5):534-9. doi: 10.1007/s 12185-016-2091-2
7. Uemura M, Tatsumi K, Matsumoto M, Fujimoto M, Matsuyama T, Ishikawa M, Iwamoto TA, Mori T, Wanaka A, Fukui H, et al. Localization of ADAMTS13 to the stellate cells of human liver. Blood. 2005;106(3):922-4. doi: 10.1182/blood-2005-01-0152
8. Fujimura Y, Matsumoto M, Yagi H, Yoshioka A, Matsui T, Titani K. Von Willebrand factor-cleaving protease and Upshaw–Schulman syndrome. Int J Hematol. 2002;75(1):25-34. doi: 10.1007/BF02981975
9. Epperla N, Hemauer K, Friedman KD, George JN, Foy P. Congenital thrombotic thrombocytopenic purpura related to a novel mutation in ADAMTS13 gene and management during pregnancy. Am J Hematol. 2016;28(10):24311. doi: 10.1002/ ajh.24311
10. Krabbe JG, Kemna EW, Strunk AL, Jobse PA, Kramer PA, Dikkeschei LD, van den Heuvel LP, Fijnheer R, Verdonck LF. Adult-onset congenital thrombotic thrombocytopenic purpura caused by a novel compound heterozygous mutation of the ADAMTS13 gene. Int J Hematol. 2015;102(4):477-81. doi: 10.1007/s12185-015-1849-2
11. Kim HY, Lee KO, Yoo KH, Kim SH, Oh D, Kim HJ. Congenital thrombotic thrombocytopenic purpura (Upshaw–Schulman syndrome) caused by novel ADAMTS13 mutations. Br J Haematol. 2016; Apr;173(1):156-9. doi: 10.1111/bjh.13564
12. Ferrari B, Cairo A, Pontiggia S, Mancini I, Masini L, Peyvandi F. Congenital and acquired ADAMTS13 deficiency: two mechanisms, one patient. J Clin Apher. 2015;30(4):252-6. doi: 10.1002/jca.21366
13. Benevides TC, Orsi FA, Colella MP, Percout Pde O, Moura MS, Dias MA, Lins BD, Paula EV, Vassallo J, Annichino- Bizzachi J. Acquired thrombotic thrombocytopenic purpura due to antibody-mediated ADAMTS13 deficiency precipitated by a localized Castleman’s disease: a case report. Platelets. 2015;26(3):263-6. doi: 10.3109/09537104.2014.904504
14. Mariotte E, Azoulay E, Galicier L, Rondeau E, Zouiti F, Boisseau P, Poullin P, de Maistre E, Provôt F, Delmas Y, Perez P, Benhamou Y, Stepanian A, Coppo P, Veyradier A. Epidemiology and pathophysiology of adulthood-onset thrombotic microangiopathy with severe ADAMTS13 deficiency (thrombotic thrombocytopenic purpura): a cross-sectional analysis of the French national registry for thrombotic microangiopathy. Lancet Haematol. 2016 May;3(5):e237-45 [Medline]. doi: 10.1016/S2352-3026(16)30018-7
15. Miller DP, Kaye JA, Shea K, Ziyadeh N, Cali C, Black C, Walker AM. Incidence of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. Epidemiology. 2004 Mar;15(2):208-15 [Medline]. doi:10.1097/01.ede.000011327 3.14807.53
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1. Joly BS, Coppo P, Veyradier A. Thrombotic thrombocytopenic purpura. Blood. 2017 May 25;129(21):2836-46 [Medline]. doi: 10.1182/blood-2016-10-709857
2. Thrombotic thrombocytopenic purpura. https://emedicine.medscape.com/ article/206598-overview#a5 ссылка активна на 04.07.2018
3. Moschcowitz E. https://en.wikipedia.org/wiki/Eli_Moschcowitz ссылка активна на 04.07.2018
4. Moake JL. Thrombotic microangiopathies. N Engl J Med. 2002;347(8):589-600. doi: 10.1056/NEJMra020528
5. Benz K, Amann K. Pathological aspects of membranoproliferative glomerulonephritis (MPGN) and haemolytic uraemic syndrome (HUS) / thrombocytic thrombopenic purpura (TTP). Thromb Haemost. 2009;101:265-70. doi: 10.1160/TH07-12-0761
6. Feng Y, Li X, Xiao J, Li W, Liu J, Zeng X, Chen X, Chen S. ADAMTS13: more than a regulator of thrombosis. Int J Hematol. 2016;104(5):534-9. doi: 10.1007/s 12185-016-2091-2
7. Uemura M, Tatsumi K, Matsumoto M, Fujimoto M, Matsuyama T, Ishikawa M, Iwamoto TA, Mori T, Wanaka A, Fukui H, et al. Localization of ADAMTS13 to the stellate cells of human liver. Blood. 2005;106(3):922-4. doi: 10.1182/blood-2005-01-0152
8. Fujimura Y, Matsumoto M, Yagi H, Yoshioka A, Matsui T, Titani K. Von Willebrand factor-cleaving protease and Upshaw–Schulman syndrome. Int J Hematol. 2002;75(1):25-34. doi: 10.1007/BF02981975
9. Epperla N, Hemauer K, Friedman KD, George JN, Foy P. Congenital thrombotic thrombocytopenic purpura related to a novel mutation in ADAMTS13 gene and management during pregnancy. Am J Hematol. 2016;28(10):24311. doi: 10.1002/ ajh.24311
10. Krabbe JG, Kemna EW, Strunk AL, Jobse PA, Kramer PA, Dikkeschei LD, van den Heuvel LP, Fijnheer R, Verdonck LF. Adult-onset congenital thrombotic thrombocytopenic purpura caused by a novel compound heterozygous mutation of the ADAMTS13 gene. Int J Hematol. 2015;102(4):477-81. doi: 10.1007/s12185-015-1849-2
11. Kim HY, Lee KO, Yoo KH, Kim SH, Oh D, Kim HJ. Congenital thrombotic thrombocytopenic purpura (Upshaw–Schulman syndrome) caused by novel ADAMTS13 mutations. Br J Haematol. 2016; Apr;173(1):156-9. doi: 10.1111/bjh.13564
12. Ferrari B, Cairo A, Pontiggia S, Mancini I, Masini L, Peyvandi F. Congenital and acquired ADAMTS13 deficiency: two mechanisms, one patient. J Clin Apher. 2015;30(4):252-6. doi: 10.1002/jca.21366
13. Benevides TC, Orsi FA, Colella MP, Percout Pde O, Moura MS, Dias MA, Lins BD, Paula EV, Vassallo J, Annichino- Bizzachi J. Acquired thrombotic thrombocytopenic purpura due to antibody-mediated ADAMTS13 deficiency precipitated by a localized Castleman’s disease: a case report. Platelets. 2015;26(3):263-6. doi: 10.3109/09537104.2014.904504
14. Mariotte E, Azoulay E, Galicier L, Rondeau E, Zouiti F, Boisseau P, Poullin P, de Maistre E, Provôt F, Delmas Y, Perez P, Benhamou Y, Stepanian A, Coppo P, Veyradier A. Epidemiology and pathophysiology of adulthood-onset thrombotic microangiopathy with severe ADAMTS13 deficiency (thrombotic thrombocytopenic purpura): a cross-sectional analysis of the French national registry for thrombotic microangiopathy. Lancet Haematol. 2016 May;3(5):e237-45 [Medline]. doi: 10.1016/S2352-3026(16)30018-7
15. Miller DP, Kaye JA, Shea K, Ziyadeh N, Cali C, Black C, Walker AM. Incidence of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. Epidemiology. 2004 Mar;15(2):208-15 [Medline]. doi:10.1097/01.ede.000011327 3.14807.53
1 ГБУЗ Свердловской области «Свердловская областная клиническая больница №1», Екатеринбург, Россия;
2 Институт биологии развития им. Н.К. Кольцова, Москва, Россия;
3 Уральский государственный медицинский университет Минздрава России, Екатеринбург, Россия;
4 ГБУЗ «Городская клиническая больница №52» Департамента здравоохранения города Москвы, Москва, Россия;
5 Московский государственный медико-стоматологический университет им. А.И. Евдокимова Минздрава России, Москва, Россия
1 Sverdlovsk Regional Clinical Hospital No. 1, Yekaterinburg, Russia;
2 Koltsov Institute of developmental biology, Moscow, Russia;
3 Ural State Medical University, Yekaterinburg, Russia;
4 City Clinical Hospital No. 52, Moscow, Russia;
5 Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia