Division of Hematology, Department of Medicine, University of Texas, Houston, Texas 77030, USA.
Am J Hematol. 2013 Mar;88(3):237-9. doi: 10.1002/ajh.23249. Epub 2012 May 28.
An atypical clinical presentation makes TTP diagnosis difficult, which prevents prompt management of TTP. This case highlights the importance of early recognition of TTP in patients with atypical presentations who may not have the expected clinical or laboratory findings. The level of suspicion should be especially high in young and middle-aged patients with strokes or acute coronary syndrome who do not have other risk factors for cardiovascular events. This is particularly so for those patients who have a previous episode of TTP or patients with subtle laboratory abnormalities, which may suggest the potential existence of a thrombotic microangiopathic process.
不典型的临床表现使 TTP 的诊断变得困难，从而无法及时对 TTP 进行治疗。本病例强调了对可能没有预期临床或实验室发现的不典型表现的 TTP 患者进行早期识别的重要性。对于没有其他心血管事件危险因素的年轻和中年脑卒中或急性冠脉综合征患者，应特别提高对 TTP 的怀疑程度。对于那些有 TTP 既往发作史或有细微实验室异常的患者，情况更是如此，这可能提示存在血栓性微血管病过程的潜在可能性。
