Iosifidis Michael I, Ntavlis Merkourios, Giannoulis Ioannis, Malioufas Leonidas, Ioannou Antonios, Giantsis Georgios
Orthopaedic Department, Naoussa General Hospital Naoussa, 21 Filiaton-Ikarou Str, 55438 Thessaloniki, Greece.
Arch Orthop Trauma Surg. 2006 Jul;126(5):335-8. doi: 10.1007/s00402-005-0014-4. Epub 2006 Mar 9.
Thrombotic thrombocytopenic purpura (TTP) or Moschowitz's syndrome is characterized by release of unusually large von Willebrand factor (ULvWF) multimers and a deficiency of vWF metalloprotease. It is a very rare condition, but it causes serious problems. The etiology is still unknown, although surgical stress has been associated with TTP, probably by releasing massive amounts of ULvWF. TTP is an acute, recurrent disease of the circulatory system, consisting of thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological signs, and renal dysfunction. It has the strong possibility of being fatal and thus should be treated immediately, mostly by plasmapheresis. We report a case of TTP following a high tibial valgus osteotomy. An association between TTP and orthopedic surgery--as far as we know--has only once been reported in the literature. We suggest that orthopedic surgeons should be aware of this because, although very rare, postsurgical TTP could be a life-threatening postoperative complication, which needs prompt diagnosis and treatment.
血栓性血小板减少性紫癜（TTP）或莫乔维茨综合征的特征是异常大的血管性血友病因子（ULvWF）多聚体的释放以及血管性血友病因子金属蛋白酶的缺乏。这是一种非常罕见的病症，但会引发严重问题。尽管手术应激可能通过释放大量ULvWF与TTP相关，但病因仍不明。TTP是一种急性复发性循环系统疾病，由血小板减少、微血管病性溶血性贫血、发热、神经体征和肾功能不全组成。它极有可能致命，因此应立即治疗，主要通过血浆置换。我们报告一例高位胫骨外翻截骨术后发生TTP的病例。据我们所知，TTP与骨科手术之间的关联在文献中仅被报道过一次。我们建议骨科医生应意识到这一点，因为尽管术后TTP非常罕见，但可能是一种危及生命的术后并发症，需要及时诊断和治疗。
