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高血压急症作为获得性血栓性血小板减少性紫癜的首发表现:一例报告

Hypertensive Emergency as the Initial Presentation of Acquired Thrombotic Thrombocytopenic Purpura: A Case Report.

作者信息

Zamora Diana I, Gonzalez Laura M

机构信息

General Medicine, Universidad de Ciencias Medicas, San Jose, CRI.

出版信息

Cureus. 2021 Dec 5;13(12):e20176. doi: 10.7759/cureus.20176. eCollection 2021 Dec.

DOI:10.7759/cureus.20176
PMID:34877232
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8645183/
Abstract

Thrombotic thrombocytopenic purpura (TTP) is a type of thrombotic microangiopathy (TMA) related to a deficiency of ADAMTS13 protein, which could lead to fatal outcomes. TTP presents a vast array of symptoms, making its diagnosis a challenge to physicians. In this report, we discuss the case of an 80-year-old male who presented with abdominal pain and hypertension with underlying severe thrombocytopenia and hemolysis. Although his presentation could also be secondary to malignant hypertension, he was promptly diagnosed with TTP based on these findings. TTP is a hematologic emergency, and it should be kept in the differential diagnosis when a patient presents with thrombocytopenia and hemolysis with or without accompanying symptoms.

摘要

血栓性血小板减少性紫癜(TTP)是一种与ADAMTS13蛋白缺乏相关的血栓性微血管病(TMA),可导致致命后果。TTP症状繁多,给医生的诊断带来挑战。在本报告中,我们讨论了一名80岁男性患者的病例,该患者出现腹痛和高血压,伴有严重血小板减少和溶血。尽管他的症状也可能继发于恶性高血压,但基于这些发现,他被迅速诊断为TTP。TTP是一种血液学急症,当患者出现血小板减少和溶血,伴或不伴有其他症状时,应将其纳入鉴别诊断。

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本文引用的文献

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Thrombotic thrombocytopenic purpura with reversible splenial lesion syndrome: a case report.血栓性血小板减少性紫癜伴可逆性胼胝体病变综合征:一例报告。
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Thrombotic Thrombocytopenic Purpura, Heparin-Induced Thrombocytopenia, and Disseminated Intravascular Coagulation.血栓性血小板减少性紫癜、肝素诱导的血小板减少症和弥散性血管内凝血。
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Systemic Lupus Erythematosus Presenting as Refractory Thrombotic Thrombocytopenic Purpura: A Diagnostic and Management Challenge. A Case Report and Concise Review of the Literature.以难治性血栓性血小板减少性紫癜为表现的系统性红斑狼疮:诊断与管理挑战。病例报告及文献简要综述
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Remission in acute refractory and relapsing thrombotic thrombocytopenic purpura following rituximab is associated with a reduction in IgG antibodies to ADAMTS-13.利妥昔单抗治疗后,急性难治性和复发性血栓性血小板减少性紫癜的缓解与抗ADAMTS-13 IgG抗体的减少有关。
Br J Haematol. 2007 Feb;136(3):451-61. doi: 10.1111/j.1365-2141.2006.06448.x.
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Hypertens Res. 2005 Jan;28(1):89-95. doi: 10.1291/hypres.28.89.