Talwalkar Jayant A, Ruymann Frederick W, Marcoux Paul, Farraye Francis A
Division of Gastroenterology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Dig Dis Sci. 2002 May;47(5):1096-9. doi: 10.1023/a:1015098325971.
Pancreatitis is a known complication of thrombotic thrombocytopenic purpura (TTP) found in approximately 2% of cases. The development of TTP as a clinical sequelae of acute pancreatitis has also been reported, including one patient with chronic pancreatitis who developed TTP on two occasions following acute exacerbations of pancreatitis. We describe a case in which multiple distinct episodes of TTP have followed the clinical and laboratory demonstration of acute pancreatitis in the same patient. Supportive care of the patient's pancreatitis and plasmapheresis in each case resulted in clinical improvement and resolution of TTP. While the pathophysiologic mechanism explaining this association remains unclear, the recurrence of TTP associated with the "rechallenge" of relapsing episodes of pancreatitis in our patient suggests that a cause-and-effect relationship does exist.
胰腺炎是血栓性血小板减少性紫癜（TTP）的一种已知并发症，约2%的病例中会出现。也有报道称TTP是急性胰腺炎的临床后遗症，包括1例慢性胰腺炎患者在胰腺炎急性加重后两次发生TTP。我们描述了1例患者，在急性胰腺炎的临床和实验室表现之后出现了多次不同的TTP发作。对该患者的胰腺炎进行支持治疗并在每种情况下进行血浆置换，均使临床症状改善且TTP得到缓解。虽然解释这种关联的病理生理机制尚不清楚，但我们患者中TTP与胰腺炎复发“再激发”相关的复发情况表明因果关系确实存在。
