Diop Ndoye M, Mouloungui C, Diouf E, Kane O, Bèye M D, Bah D, Ka Sall B
Service Anesthésie-réanimation, Hôpital Aristide Le Dantec.
Dakar Med. 2006;51(2):68-71.
Thrombotic thrombocytopenic purpura failure (TTP) is a micro angiopathy caracterized in its severe form by multivisceral involement and early death. The association with pregnancy is rare, the diagnosis is difficult, but imperative because that will allow an early specific management and will improve the diagnosis
Our patient is a 25 years old woman admitted in intensive care unit after cesarian section for eclampsia at term. Clinical and biological assessement were in favor at Hellp syndrome. Toxemia complicated with eclampsia and Hell syndrome was the final diagnosis and appropriate treatment followed. However the treatment, diffuse purpuric petechia appeared associated with jaundice, thrombocytopenia. The diagnosis of T.T.P was considered and corticotherapy started at day 8. Patient responded within 48 h and healins was complete after 5 weeks.
Authors emphasized on the importance of the diagnosis and specific management.
血栓性血小板减少性紫癜(TTP)是一种微血管病,其严重形式的特征是多脏器受累和早期死亡。与妊娠相关的情况罕见,诊断困难,但至关重要,因为这将允许早期进行特异性治疗并改善预后。
我们的患者是一名25岁女性,因足月子痫行剖宫产术后入住重症监护病房。临床和生物学评估支持HELLP综合征。最终诊断为子痫并发毒血症和HELL综合征,并进行了适当治疗。然而,治疗过程中出现了弥漫性紫癜瘀点,伴有黄疸、血小板减少。考虑诊断为TTP,并在第8天开始使用皮质激素治疗。患者在48小时内有反应,5周后完全康复。
作者强调了诊断和特异性治疗的重要性。