Ge Hangping, Shi Zhan, Zheng Zhiyin, Zhu Qiuping, Hong Lili, Zhang Yu, Shen Jianping, Deng Shu
Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54, Youdian Road, Hangzhou, China.
Zhejiang Chinese Medical University, Bingwen Road, Hangzhou, China.
J Int Med Res. 2022 Mar;50(3):3000605221085127. doi: 10.1177/03000605221085127.
A 33-year-old Chinese woman with a history of immune thrombocytopenic purpura presented with heavy menstrual bleeding. She was found to have thrombocytopenia, plasma ADAMTS13 activity of 0%, and positivity for the plasma ADAMTS13 inhibitor. She was diagnosed with the coexistence of thrombotic thrombocytopenic purpura and immune thrombocytopenic purpura. The patient was treated by plasmapheresis, a glucocorticoid, and rituximab. Her platelet level returned to normal, and she was discharged 28 days after admission. The number of plasmapheresis sessions and the timing of rituximab administration may be the key aspects of management of patients with thrombotic thrombocytopenic purpura who have underlying immune dysfunction caused by diseases such as immune thrombocytopenic purpura.
一名33岁有免疫性血小板减少性紫癜病史的中国女性出现月经过多。她被发现有血小板减少症，血浆ADAMTS13活性为0%，血浆ADAMTS13抑制剂呈阳性。她被诊断为血栓性血小板减少性紫癜和免疫性血小板减少性紫癜并存。该患者接受了血浆置换、糖皮质激素和利妥昔单抗治疗。她的血小板水平恢复正常，入院28天后出院。血浆置换的次数和利妥昔单抗给药的时机可能是治疗因免疫性血小板减少性紫癜等疾病导致潜在免疫功能障碍的血栓性血小板减少性紫癜患者的关键管理方面。
