{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:00:47Z","timestamp":1754398847465},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,5,16]],"date-time":"2016-05-16T00:00:00Z","timestamp":1463356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:p>Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy often caused by deficiency of von Willebrand (vW) factor cleaving protease, ADAMTS\u201013, leading to large vW multimers and intravascular platelet aggregation. Hemolysis in TTP is mechanical and nonimmune mediated, thus Coombs testing is usually negative. We report a case of an adolescent with thrombocytopenia and Coombs positive anemia, diagnosed with Evans syndrome, but ultimately found to have TTP. TTP should be considered in children with thrombocytopenia and Coombs positive anemia who are refractory to steroids or develop signs of microangiopathy.\u00a0 Recognition of this presentation can lead to life\u2010saving treatment with plasma exchange.<\/jats:p>","DOI":"10.1002\/pbc.26068","type":"journal-article","created":{"date-parts":[[2016,5,20]],"date-time":"2016-05-20T04:13:19Z","timestamp":1463717599000},"page":"1860-1862","source":"Crossref","is-referenced-by-count":6,"title":["Coombs Positive Thrombotic Thrombocytopenic Purpura in a Male Pediatric Patient: An Urgent Diagnostic Challenge"],"prefix":"10.1002","volume":"63","author":[{"given":"Anna","family":"Zenno","sequence":"first","affiliation":[{"name":"Baystate Medical Center Tufts University School of Medicine  Springfield Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Richardson","sequence":"additional","affiliation":[{"name":"Baystate Medical Center Tufts University School of Medicine  Springfield Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,16]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"21","article-title":"Hyaline thrombosis of the terminal arterioles and capillaries: A hitherto undescribed disease","volume":"24","author":"Moschcowitz E","year":"1924","journal-title":"Proc NY Pathol Soc"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1312353"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21248"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2003.10.007"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01350.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05809.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24612"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(56)90045-6"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2014.02.041"},{"key":"e_1_2_5_11_1","first-page":"468","article-title":"Case of thrombotic thrombocytopenic purpura with a positive Coomb test","volume":"47","author":"Urahama Y","year":"2005","journal-title":"Nihon Jinzo Gakkai Shi"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199601)51:1<1::AID-AJH1>3.0.CO;2-2"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.26068","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.26068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T15:13:39Z","timestamp":1695741219000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.26068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,16]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1002\/pbc.26068"],"URL":"https:\/\/doi.org\/10.1002\/pbc.26068","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,16]]}}}