Falter Tanja, Schmitt Veronique, Herold Stephanie, Weyer Veronika, von Auer Charis, Wagner Stefanie, Hefner Gudrun, Beutel Manfred, Lackner Karl, Lämmle Bernhard, Scharrer Inge
Institute of Clinical Chemistry and Laboratory Medicine.
Center for Thrombosis and Hemostasis (CTH).
Transfusion. 2017 May;57(5):1152-1162. doi: 10.1111/trf.14060. Epub 2017 Mar 24.
Thrombotic thrombocytopenic purpura (TTP) is an acute life-threatening microangiopathy with a tendency of relapse characterized by consumptive thrombocytopenia, microangiopathic hemolytic anemia, and spontaneous von Willebrand factor-induced platelet clumping leading to microthrombi. The brain is frequently affected by microthrombi leading to neurologic abnormalities of varying severity.
The aim of this observational cohort study was to investigate the prevalence of depression and cognitive deficits in 104 patients having survived acute TTP. TTP survivors were repeatedly assessed by means of different standardized questionnaires to evaluate depression (IDS-SR) and mental performance (FLei). We received answers of 104 individual TTP patients and 55 of them participated in both surveys.
Seventy-one of the 104 responding TTP patients (68%) suffered from depression and the severity of depression was similar in both surveys performed 1 year apart. Furthermore, TTP patients had considerably lower cognitive performance than controls. There was no correlation between prevalence of depression and cognitive deficits and the number and the severity of acute episodes. Impairment of mental performance correlated with the severity of depression (r = 0.779).
The prevalence of depression and cognitive deficits was significantly higher in TTP patients. Cognitive impairment seemed to be a consequence of depression, almost independently of number and severity of TTP episodes.
血栓性血小板减少性紫癜（TTP）是一种急性危及生命的微血管病，有复发倾向，其特征为消耗性血小板减少、微血管病性溶血性贫血，以及自发性血管性血友病因子诱导的血小板聚集导致微血栓形成。脑部常受微血栓影响，导致不同严重程度的神经功能异常。
这项观察性队列研究的目的是调查104例急性TTP存活患者中抑郁症和认知缺陷的患病率。通过不同的标准化问卷对TTP幸存者进行反复评估，以评估抑郁症（IDS-SR）和心理表现（FLei）。我们收到了104例个体TTP患者的回复，其中55例参与了两项调查。
104例回复的TTP患者中有71例（68%）患有抑郁症，且在相隔1年进行的两项调查中抑郁症严重程度相似。此外，TTP患者的认知表现明显低于对照组。抑郁症患病率和认知缺陷与急性发作的次数和严重程度之间无相关性。心理表现受损与抑郁症严重程度相关（r = 0.779）。
TTP患者中抑郁症和认知缺陷的患病率显著更高。认知障碍似乎是抑郁症的结果，几乎与TTP发作的次数和严重程度无关。
