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急性胰腺炎诱发的血栓性血小板减少性紫癜:一例报告

Acute pancreatitis-induced thrombotic thrombocytopenic purpura: A case report.

作者信息

Wang Chun-Hua, Jin Hai-Feng, Liu Wen-Ge, Guo Ying, Liu Zhen

机构信息

Department of Gastroenterology, The 980 Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang 050082, Hebei Province, China.

出版信息

World J Clin Cases. 2022 Apr 26;10(12):3808-3813. doi: 10.12998/wjcc.v10.i12.3808.

Abstract

BACKGROUND

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening but treatable disorder. Acute pancreatitis is a well-described consequence of TTP, but TTP as a consequence of acute pancreatitis is rare.

CASE SUMMARY

A 32-year-old male developed acute pancreatitis due to a fatty diet and suffered splenectomy 3 years ago due to trauma. From day 4 of his onset of pain the blood examination showed the platelet extremely reduced, bilirubin elevated and creatinine increased. High clinical suspicion of TTP was made and prompt initiation of plasma exchange was given followed intravenous drip methylprednisolone. After 7 sessions of plasm exchange and the laboratory parameters were back to normal and the patient was discharged from the hospital on the 13 day of admission.

CONCLUSION

Patients develop acute pancreatitis with no apparent causes for hemolytic anemia and thrombocytopenia, the possibility of TTP should be considered. Treatments for TTP including plasm exchange should be evaluated as soon as a diagnosis is made.

摘要

背景

血栓性血小板减少性紫癜(TTP)是一种危及生命但可治疗的疾病。急性胰腺炎是TTP一种已被充分描述的后果,但急性胰腺炎导致的TTP却很罕见。

病例摘要

一名32岁男性因高脂饮食引发急性胰腺炎,3年前因外伤行脾切除术。自疼痛发作第4天起,血液检查显示血小板极度减少、胆红素升高及肌酐增加。高度怀疑为TTP,立即开始血浆置换,并静脉滴注甲泼尼龙。经过7次血浆置换后,实验室指标恢复正常,患者于入院第13天出院。

结论

患者出现无明显病因的急性胰腺炎伴溶血性贫血和血小板减少时,应考虑TTP的可能性。一旦确诊TTP,应尽快评估包括血浆置换在内的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/592c/9100735/d6de82144455/WJCC-10-3808-g001.jpg

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