Abstract: TH-PO0488
Severe Thrombocytopenia Associated with CRRT
Session Information
- Hemodialysis: Novel Markers and Case Reports
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Alhammadi, Mariam, King Hamad University Hospital, Muharraq, Muharraq Governorate, Bahrain
- Alanazi, Talal Hamad, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Elfar, Ahmed F., King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
Introduction
Thrombocytopenia is a common complication encountered in an intensive care unit (ICU) setting, often resulting from variable causes including Heparin-induced thrombocytopenia, medications-induced thrombocytopenia or sepsis induced (1). Thrombocytopenia is frequently associated with renal replacement therapy (RRT). Studies reported a decline in platelet count with the initiation of RRT, in most of the cases thrombocytopenia is mild to moderate (2). We present a case of severe thrombocytopenia in which numerous causes were ruled out, Thrombotic Thrombocytopenia Purpura (TTP) initially was suspected given a low ADAMST13 level, However the patient underwent plasma exchange session with no improvement. The platelet count recovered after discontinuing continuous renal replacement therapy (CRRT).
Case Description
40-year-old female, with past medical history of restrictive hypertrophic cardiomyopathy, atrial fibrillation, heart failure with reduced ejection fraction, and chronic kidney disease stage 3A.
The patient was admitted with the impression of acute decompensated heart failure.During hospitalization, her condition deteriorated in which inotropic support was required. Her renal function worsened, and she required CRRT initiation. Meanwhile, the patient developed severe thrombocytopenia with platelet count reaching 8 10^9/L. Work up including an autoimmune profile, cold agglutinin, and antiphospholipid antibodies was negative. The patient had a low ADAMST13 level with intermediate plasmic score, TTP was suspected. Despite undergoing plasma exchange, platelet counts didn’t recover. After discontinuing the CRRT, platelet counts improved markedly within 48 hours.
Discussion
CRRT could be a possible rare cause of severe thrombocytopenia in ICU sitting. Exclusion of other causes is required before concluding that CRRT induces thrombocytopenia. In our case, we reported severe thrombocytopenia with almost complete recovery of platelet count after discontinuation of CRRT.
Platelet count in relation to CRRT