Koyama T, Oura Y, Kakishita E, Nagai K, Matsuda T, Taira S, Isojima S
Second Department of Internal Medicine, Hyogo College of Medicine, Japan.
Jpn J Med. 1987 Aug;26(3):381-4. doi: 10.2169/internalmedicine1962.26.381.
A 28-year-old female, who suffered from thrombotic thrombocytopenic purpura (TTP) in the 14th week of her first pregnancy, recovered after a plasma exchange followed by an induced abortion. From six months after the abortion, she no longer required plasma infusions every 3-4 weeks to prevent a relapse of TTP manifested as thrombocytopenia, and complete remission continued until her next pregnancy. In her second pregnancy, she had an immediate relapse of TTP and responded to plasma infusion until the 24th week. However, the TTP gradually became resistant to plasma infusion, and developed into toxemia with edema, hypertension and proteinuria in the 27th week. Although the TTP was alleviated by the infusion of large amounts of plasma, the placenta failed as the result of numerous white infarcts. She delivered a 948 g live baby by cesarean section in the 33rd week. The baby had transient thrombocytopenia but did not suffer from TTP. The mother required plasma infusions every 3-4 weeks for about five months, and she has continued in remission.
一名28岁女性，在首次怀孕第14周时患上血栓性血小板减少性紫癜（TTP），在进行血浆置换并引产之后康复。流产后六个月起，她不再需要每3至4周输注一次血浆以预防表现为血小板减少的TTP复发，完全缓解状态持续至她再次怀孕。第二次怀孕时，她TTP立即复发，在第24周前对血浆输注有反应。然而，TTP逐渐对血浆输注产生抵抗，并在第27周发展为伴有水肿、高血压和蛋白尿的毒血症。尽管通过输注大量血浆使TTP得到缓解，但由于大量白色梗死灶，胎盘功能衰竭。她在第33周通过剖宫产分娩出一名体重948克的活婴。婴儿有短暂性血小板减少，但未患TTP。母亲在大约五个月的时间里需要每3至4周输注一次血浆，目前仍处于缓解状态。
