Interferon beta-lb-induced thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) in a patient treated for multiple sclerosis: A case report

Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are currently the two basic forms of thrombotic microangiopathies (TMA). Due to the extreme similarities in their clinical manifestations, they are often considered as one condition known as TTP-HUS. TTP-HUS is characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, and neurologic and renal abnormalities. Neurologic symptoms include headache, vertigo, confusion, seizures, and other symptoms. The mechanism of these symptoms is due to the obstruction of small blood vessels which causes secondary organ damage due to ischemia.1 Moreover, studying the literature shows that TTP-HUS has been reported in association with many inflammatory diseases and treatment with certain drugs.2 Multiple sclerosis (MS) is a demyelinating disease of the central nervous system which is treated with several drugs including interferon beta.2 Interferon beta-1a and interferon beta-1b have induced TTP-HUS in cases of patients with MS worldwide.