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登革热相关性血栓性血小板减少性紫癜。

Thrombotic Thrombocytopenic Purpura in Dengue Fever.

机构信息

Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, JalanYaacob Latif, Bandar TunRazak, 56000 Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia.

出版信息

Acta Med Indones. 2021 Apr;53(2):208-212.

Abstract

Thrombotic thrombocytopenic purpura is a rare but life threatening medical condition. Early recognition and treatment of thrombotic thrombocytopenic purpura is important especially in patients who do not present with the classic pentad to reduce the high mortality. Herein, we describe a case of a patient who does not fulfil the classic pentad features thrombotic thrombocytopenic purpura that was induced by dengue fever. The patients' initial full blood picture did not have all the typical features of microangiopathic haemolytic anaemia but there were fragmented red blood cells. However, even a small number of fragmented red blood cells in the peripheral blood should alert physicians of the possible diagnosis of thrombotic thrombocytopenic purpura together with other symptoms. Furthermore, signs and symptoms of thrombotic thrombocytopenic purpura and dengue fever can overlap such as fever, thrombocytopenia, neurological deficit mimicking dengue encephalopathy and dengue induced acute kidney injury.

摘要

血栓性血小板减少性紫癜是一种罕见但危及生命的疾病。早期识别和治疗血栓性血小板减少性紫癜尤为重要,特别是对于那些没有出现经典五联征的患者,以降低高死亡率。在此,我们描述了一例由登革热引起的不符合经典五联征特征的血栓性血小板减少性紫癜患者。该患者最初的全血细胞计数并没有微血管性溶血性贫血的所有典型特征,但存在破碎的红细胞。然而,外周血中即使只有少量破碎的红细胞,也应该引起医生警惕可能的血栓性血小板减少性紫癜诊断,同时结合其他症状。此外,血栓性血小板减少性紫癜和登革热的体征和症状可能重叠,如发热、血小板减少、神经功能缺损类似于登革热脑病和登革热引起的急性肾损伤。

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