Medical Oncology Hematology, AIIMS Rishikesh, Rishikesh, India.
Pediatric Hematology Oncology, Superspeciality Pediatric Hospital & PG Teaching Institute, Noida, India.
J Thromb Thrombolysis. 2021 Aug;52(2):504-507. doi: 10.1007/s11239-021-02452-0. Epub 2021 Apr 27.
Thrombotic thrombocytopenic purpura (TTP) which can cause significant mortality is a thrombotic microangiopathy due to deficiency of VWF cleaving protease ADAMTS13 and as per medical literature there are examples that TTP can be caused by COVID 19 infection. A 35 years old female after admission with right sided weakness and slurring of speech was found to be COVID positive and diagnosed as a case of TTP. Patient had absent ADAMTS13 level on day 1. Treatment was started with therapeutic plasma exchange (TPE) later injection Vincristine and Rituximab was given after 4th TPE as it was suspected as refractory case. Finally patient received 16 TPE procedures with cryo poor plasma as exchange fluid and gradually her platelet count started to maintain normal and she was discharged. Specific management and such association of this type of cases need to be studied more judiciously.
血栓性血小板减少性紫癜（TTP）可导致高死亡率，是一种由于 VWF 切割蛋白酶 ADAMTS13 缺乏引起的血栓性微血管病。根据医学文献记载，TTP 可由 COVID-19 感染引起。一位 35 岁女性因右侧无力和言语不清入院，COVID-19 检测呈阳性，并被诊断为 TTP 病例。患者在第 1 天 ADAMTS13 水平缺失。治疗开始时采用治疗性血浆置换（TPE），第 4 次 TPE 后给予长春新碱和利妥昔单抗，因为怀疑为难治性病例。最终，患者接受了 16 次 TPE 治疗，使用冷冻缺乏的血浆作为置换液，血小板计数逐渐恢复正常，随后出院。需要更谨慎地研究此类病例的具体管理和这种关联。
