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登革热与基孔肯雅病毒合并感染相关的血栓性血小板减少性紫癜:流行期间的病例报告

Thrombotic thrombocytopenic purpura associated with dengue and chikungunya virus coinfection: case report during an epidemic period.

作者信息

Bastos Maria Luiza Almeida, Araújo Ruth Maria Oliveira de, Oliveira Deivide de Sousa, Cavalcante Ana Nery Melo, Silva Junior Geraldo Bezerra da

机构信息

Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Ceará, Brazil.

Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2018;60:e48. doi: 10.1590/s1678-9946201860048. Epub 2018 Sep 13.

Abstract

The present report shows the occurrence of thrombotic thrombocytopenic purpura (TTP) associated with acute dengue and chikungunya virus coinfection, manifesting as a severe disease with high mortality potential. The patient was a 28 year-old man with clinical and epidemiological diagnosis of arboviruses infections who developed thrombocytopenia and anemia, after which oral corticosteroid therapy was started. On the third day of hospitalization, he showed neurological alterations that simulated a cerebral vascular accident, but the imaging examination did not identify ischemic or hemorrhagic alterations. At that moment, the TTP hypothesis was raised so that plasmapheresis and corticosteroid pulse therapy were started, have been essential for the favorable evolution of the case.

摘要

本报告显示了与急性登革热和基孔肯雅病毒合并感染相关的血栓性血小板减少性紫癜(TTP)的发生,表现为一种具有高死亡风险的严重疾病。该患者为一名28岁男性,经临床和流行病学诊断为虫媒病毒感染,出现血小板减少和贫血,随后开始口服皮质类固醇治疗。住院第三天,他出现了类似脑血管意外的神经功能改变,但影像学检查未发现缺血性或出血性改变。此时提出了TTP的假设,于是开始了血浆置换和皮质类固醇冲击治疗,这些治疗对于该病例的良好转归至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e57c/6169087/18c500d91e3a/1678-9946-rimtsp-60-S1678-9946201860048-gf01.jpg

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