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The treatment aspects of TMA in AOSD are actively being debated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medline search using MeSH terms and snowballing yielded a total of 29 articles with co\u2010occurrence of AOSD and thrombotic thrombocytopenic purpura (TTP) including our own. Pooled data were synthesized for descriptive analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age was 35\u2009years with a majority of females (68.96%). A majority of these studies\/patients were either Asian (34.48%) or Caucasian (31.03%). Concurrent TMA at the time of AOSD diagnosis was seen in 65.51% patients. Only 3\/29 patients had ADAMTS13 level less than 10%, consistent with TTP and 3\/29 were diagnosed with hemolytic uremic syndrome (HUS). The remainder were diagnosed clinically. Complication rate was high, and 15\/29 (51.72%) patients died or had permanent neurological\/renal\/vision\/gangrenous complications. Median and mean ferritin peak was observed to be higher (7458 and 12\u2009349, respectively) in patients who either died\/had partial remission, compared to those who had complete response (3257 and 10\u2009899, respectively), <jats:italic>p<\/jats:italic>\u2009=\u2009.829.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A majority of patients with AOSD\u2010associated TMA either died or had permanent complications. TMA was diagnosed alongside AOSD in 65% patients, while the rest developed TMA during the course of their disease. Blurred vision may precede TMA and could help risk\u2010stratify high\u2010risk AOSD patients clinically. Glycosylated ferritin remains low several weeks to months after disease remission and may be used to monitor severity of disease process. Further studies are necessary to confirm the existing vascular endothelial growth factor hypothesis in AOSD\u2010associated TMA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14142","type":"journal-article","created":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T01:34:58Z","timestamp":1700876098000},"page":"484-492","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Adult\u2010onset <scp>Still's<\/scp> disease with concurrent thrombotic microangiopathy: <scp>Observations<\/scp> from pooled analysis for an uncommon finding"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-8752","authenticated-orcid":false,"given":"Anil","family":"Ananthaneni","sequence":"first","affiliation":[{"name":"Division of Hematology &amp; Oncology, Department of Internal Medicine Louisiana State University Health Sciences Center  Shreveport Louisiana 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