Kathula Satheesh K, Koduri Jhansi, Mall Sunita, Chang Jae C
Department of Medicine, Wright State University, Dayton, OH, USA.
Ther Apher Dial. 2003 Jun;7(3):373-4. doi: 10.1046/j.1526-0968.2003.00058.x.
Acute thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder that has previously been described associated with various types of surgery. An association between total abdominal hysterectomy (TAH) and TTP has never been reported. Thrombotic thrombocytopenic purpura is classically characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, azotemia and neurological manifestations. Atypical manifestations of TTP include hepatitis, pancreatitis, acute respiratory distress syndrome, non-occlusive mesenteric ischemia and peripheral digital ischemia. This case report describes the occurrence of acute TTP following TAH and bilateral salpingo-oopherectomy, which manifested with typical and atypical features (i.e. hepatitis, pancreatitis). Plasma exchange therapy resulted in the complete resolution of the process.
急性血栓性血小板减少性紫癜（TTP）是一种危及生命的疾病，此前曾被描述与各种类型的手术有关。全腹子宫切除术（TAH）与TTP之间的关联从未有过报道。血栓性血小板减少性紫癜的典型特征为血小板减少、微血管病性溶血性贫血、发热、氮质血症和神经学表现。TTP的非典型表现包括肝炎、胰腺炎、急性呼吸窘迫综合征、非闭塞性肠系膜缺血和外周手指缺血。本病例报告描述了TAH及双侧输卵管卵巢切除术后发生的急性TTP，其表现既有典型特征，也有非典型特征（即肝炎、胰腺炎）。血浆置换疗法使该病程完全缓解。
