Andreadis Panagiotis, Theodoridou Stamatia, Pasakiotou Marily, Arapoglou Stergios, Gigi Eleni, Vetsiou Evaggelia, Vlachaki Efthymia
Second Department of Internal Medicine, Aristotle University, Hippokration Hospital, 54642 Thessaloniki, Greece.
Thalassemia Unit, Hippokration Hospital, 54642 Thessaloniki, Greece.
Case Rep Hematol. 2015;2015:478151. doi: 10.1155/2015/478151. Epub 2015 Nov 2.
We herein would like to report an interesting case of a patient who presented with anemia and thrombocytopenia combined with high serum Lactic Dehydrogenase where Thrombotic Thrombocytopenic Purpura was originally considered. As indicated a central venous catheter was inserted in his subclavian vein which led to mediastinal hematoma and finally intubation and Intensive Care Unit (ICU) hospitalization. After further examination patient was finally diagnosed with B12 deficiency in a setting of H hemoglobinopathy. There have been previous reports where pernicious anemia was originally diagnosed and treated as Thrombotic Thrombocytopenic Purpura but there has been none to our knowledge that was implicated with hemothorax and ICU hospitalization or correlated with thalassemia and we discuss the significance of accurate diagnosis in order to avoid adverse reactions and therapy implications.
在此，我们想要报告一个有趣的病例。该患者表现为贫血、血小板减少，同时伴有高血清乳酸脱氢酶，最初被考虑为血栓性血小板减少性紫癜。如文中所示，在其锁骨下静脉插入了一根中心静脉导管，这导致了纵隔血肿，最终患者接受插管并入住重症监护病房（ICU）。经过进一步检查，患者最终被诊断为患有血红蛋白病背景下的维生素B12缺乏症。此前有报道称，恶性贫血最初被诊断并当作血栓性血小板减少性紫癜进行治疗，但据我们所知，尚无与血胸和入住ICU相关，或与地中海贫血相关的病例。我们讨论了准确诊断的重要性，以避免不良反应和治疗影响。
