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重症监护病房中针对产后血栓性血小板减少性紫癜非典型表现及重度子痫前期的多学科团队治疗方法。

Multidisciplinary team approach for an atypical presentation of postpartum thrombotic thrombocytopenic purpura and severe preeclampsia in the Intensive Care Unit.

作者信息

Navas-Blanco Jose R, Lopez-Plaza Ileana, Galusca Dragos M

机构信息

Department of Anesthesia, Pain Management and Perioperative Medicine, Detroit, Michigan, USA.

Department of Transfusion Medicine, Henry Ford Hospital, Detroit, Michigan, USA.

出版信息

Saudi J Anaesth. 2018 Oct-Dec;12(4):640-642. doi: 10.4103/sja.SJA_204_18.

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare hematologic syndrome during pregnancy with overlapping features of severe preeclampsia and is associated with high morbidity and mortality. We present a case of postpartum TTP, associated with severe preeclampsia. Therapeutic approach for this case included corticosteroids, plasma exchange therapy, and immunomodulatory therapy. We describe the pathophysiology of TTP in pregnancy and its similarities with other disorders that constitute the thrombotic microangiopathy syndrome, as well as other clinical factors which made the final diagnosis challenging. In addition, we highlight the value of a multidisciplinary team care approach to assure an optimal outcome for this clinical scenario.

摘要

血栓性血小板减少性紫癜(TTP)是妊娠期一种罕见的血液学综合征,具有重度子痫前期的重叠特征,且与高发病率和死亡率相关。我们报告一例产后TTP病例,该病例合并重度子痫前期。该病例的治疗方法包括使用皮质类固醇、血浆置换疗法和免疫调节疗法。我们描述了妊娠期TTP的病理生理学及其与构成血栓性微血管病综合征的其他疾病的相似之处,以及导致最终诊断具有挑战性的其他临床因素。此外,我们强调了多学科团队护理方法对于确保这种临床情况获得最佳结果的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e280/6180678/0002eef2f95e/SJA-12-640-g001.jpg

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