Benington S R, McKillop A, Macartney I, Burns S
North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester, UK.
Anaesthesia. 2009 Sep;64(9):1018-21. doi: 10.1111/j.1365-2044.2009.05982.x.
A 65-year old man developed anaemia, profound thrombocytopenia and acute renal failure 2 days after transurethral resection of the prostate. Based on the clinical picture and blood film evidence of microangiopathic haemolysis, thrombotic thrombocytopenic purpura was diagnosed. The patient was treated with a course of plasma exchange, renal replacement therapy and methylprednisolone and made a good recovery. Thrombotic thrombocytopenic purpura is an uncommon cause of haematological and renal abnormalities in the postoperative period. It has a high mortality if untreated, and should be considered in the differential diagnosis of any postoperative patient with a low platelet count and anaemia, since prompt investigation and treatment is life-saving.
