Rodrigo Horacio F, Stavile Rodolfo N, Correa Marcos, Gutiérrez María M, Kicillof Sebastián, Boschero Franco
Servicio de Clínica Médica, Sala D, Hospital Interzonal General de Agudos Gral. José de San Martín, La Plata, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2015;75(4):221-4.
Thrombocytopenic thrombotic purpura (TTP) is a thrombotic microangiopathy associated with hematopoietic stem cells transplantation, pregnancy, puerperium, drugs, bloody diarrhea, a heterogeneous group of illnesses, such as malignant hypertension, autoimmune and neoplastic diseases, infections, and an idiopathic group that includes the pathologies that don't apply for the preceding clinical categories. Tuberculosis is an illness of intermediate incidence in Argentina, with increased frequency in high-risk groups. In this article, we present the case of a 60 years old male patient, with abdominal pain, cough and nocturnal sweating. He was diagnosed as having thrombocytopenia, and a few days later, microangiopathic anemia and TTP. Further examinations led TBC diagnosis based on: 1) acid fast bacillus (+++) for Ziehl Neelsen stain in bronco alveolar lavage, 2) laryngeal lesion and 3) ileocecal valve lesion. We report this case, because TBC has rarely been associated with TTP in medical literature.
血栓性血小板减少性紫癜（TTP）是一种血栓性微血管病，与造血干细胞移植、妊娠、产褥期、药物、血性腹泻、一组异质性疾病（如恶性高血压、自身免疫性和肿瘤性疾病、感染）以及包括不符合上述临床类别的病理情况的特发性组相关。结核病在阿根廷是一种发病率中等的疾病，在高危人群中发病率增加。在本文中，我们介绍了一名60岁男性患者的病例，该患者有腹痛、咳嗽和夜间盗汗。他被诊断为血小板减少症，几天后出现微血管病性贫血和TTP。进一步检查基于以下结果诊断为结核病：1）支气管肺泡灌洗中齐-尼氏染色抗酸杆菌（+++），2）喉部病变，3）回盲瓣病变。我们报告这个病例，因为在医学文献中结核病很少与TTP相关。
