Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA
Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA.
BMJ Case Rep. 2022 Feb 7;15(2):e244030. doi: 10.1136/bcr-2021-244030.
Ocular manifestations of thrombotic thrombocytopenic purpura (TTP) are uncommon, and bilateral retinal detachment is a rare presentation of TTP. We report a rare case of bilateral retinal detachment from underlying TTP in a patient presenting with vision loss. A 56-year-old man presented with a 4-day history of bilateral vision loss. Bilateral serous retinal detachment was confirmed using dilated ophthalmoscope examination. Laboratory results were significant for severe thrombocytopenia, peripheral smear revealed numerous schistocytes and ADAMTS13 activity of less than 1%. The patient was treated with plasma exchange (PLEX), prednisone, rituximab and caplacizumab. This case report highlights that prompt treatment of TTP with PLEX, prednisone, rituximab and caplacizumab could result in significant vision recovery.
血栓性血小板减少性紫癜(TTP)的眼部表现并不常见,而双侧视网膜脱离则是 TTP 的一种罕见表现。我们报告了一例罕见的 TTP 相关双侧视网膜脱离病例,该患者以视力丧失为首发表现。一名 56 岁男性因双眼视力丧失 4 天就诊。经散瞳眼底检查证实为双侧浆液性视网膜脱离。实验室结果显示严重血小板减少,外周血涂片显示大量裂体细胞,ADAMTS13 活性低于 1%。该患者接受了血浆置换(PLEX)、泼尼松、利妥昔单抗和卡普西单抗治疗。本病例报告强调,及时采用 PLEX、泼尼松、利妥昔单抗和卡普西单抗治疗 TTP 可显著改善视力。