{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:10:11Z","timestamp":1759205411639,"version":"3.44.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Thrombotic thrombocytopenic purpura (TTP) is a rare but fatal blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and multi\u2010organ dysfunction. This condition often worsens during pregnancy and the postpartum period due to physiological changes. The present study reports a case of refractory TTP in a pregnant woman with a history of positive COVID\u201019 infection who required aggressive treatment throughout her pregnancy and postpartum recovery. A 41\u2010year\u2010old pregnant woman (G3P2L2; C\/S \u00d7\u20092) presented at 6\u2009weeks of gestation with sudden hematuria, fever, and a positive COVID\u201019 PCR test. Laboratory findings revealed the presence of schistocytes on the blood smear and a platelet count of 10,000\/\u03bcL, strongly suggestive of TTP. Following hematology and gastroenterology evaluations, treatment was initiated immediately with methylprednisolone (1 mg\/kg) and plasma exchange (PLEX). At 11\u2009weeks of gestation, the patient's platelet count decreased to 12,000\/\u03bcL, with evidence of hemolysis. She underwent eight sessions of PLEX and continued oral prednisolone therapy (1 mg\/kg). The patient was subsequently discharged with a platelet count of 300,000\/\u03bcL. Weekly outpatient PLEX and oral prednisolone were maintained throughout the pregnancy. At 36\u2009weeks of gestation, the patient presented with labor pain and headache, leading to an emergency cesarean section. Postoperatively, she underwent 10 additional PLEX sessions and continued oral prednisolone treatment. She was discharged after 2\u2009weeks in stable condition, without further complications. In conclusion, post\u2010COVID\u201019 TTP could affect women and poses substantial therapeutic challenges. This case study highlights the complexities involved in managing refractory TTP during pregnancy and the postpartum period.<\/jats:p>","DOI":"10.1002\/ccr3.70878","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T04:38:39Z","timestamp":1757392719000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Can <scp>COVID<\/scp>\u201019 Lead to Refractory Thrombotic Thrombocytopenic Purpura (<scp>TTP<\/scp>) During Pregnancy and Postpartum? A Case Report and a Review of the Literature"],"prefix":"10.1002","volume":"13","author":[{"given":"Azadeh","family":"Shabani","sequence":"first","affiliation":[{"name":"Preventive Gynecology Research Center (PGRC) Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-8287","authenticated-orcid":false,"given":"Marjan","family":"Razi\u2010Khosroshahi","sequence":"additional","affiliation":[{"name":"Resident of Obstetrics &amp; Gynecology, Preventive Gynecology Research Center (PGRC) Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamide","family":"Rahmani Seraji","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Taleghani Hospital Shahid Beheshti University of Medical Science  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nafiseh","family":"Faghih","sequence":"additional","affiliation":[{"name":"Preventive Gynecology Research Center (PGRC) Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matin","family":"Hooshyar","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","first-page":"156","article-title":"Clinical Features and Risk Factors of Relapse and Mortality in Thrombotic Thrombocytopenic Purpura Patients: A Seven\u2010Year Experience","volume":"17","author":"Shiraji S. 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