Vyas Abhinav, Isaac Sangeetha, Kaur Dania, Yadav Udit
Department of Internal Medicine, North Alabama Medical Center, Florence, USA.
Department of Hematology, Mayo Clinic, Rochester, USA.
Cureus. 2023 Mar 15;15(3):e36188. doi: 10.7759/cureus.36188. eCollection 2023 Mar.
We report the case of a middle-aged male presenting with fatigue and abdominal pain. Prompt investigations demonstrated microangiopathic hemolytic anemia and thrombocytopenia on a peripheral blood smear. Thrombotic thrombocytopenic purpura was suspected based on the PLASMIC score. The patient significantly improved with therapeutic plasma exchange and prednisone within the next few days. The disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13 levels reduction is a definitive hallmark leading to microvascular thrombosis. However, some medical centers in the United States do not promptly have quick allowance to the levels. Hence, the PLASMIC score becomes imminent in initiating immediate management and preventing life-threatening complications.
我们报告了一例表现为疲劳和腹痛的中年男性病例。迅速的检查在外周血涂片上显示微血管病性溶血性贫血和血小板减少。基于PLASMIC评分怀疑为血栓性血小板减少性紫癜。在接下来的几天里，患者通过治疗性血浆置换和泼尼松显著改善。具有血小板反应蛋白1型基序的去整合素和金属蛋白酶13水平降低是导致微血管血栓形成的明确标志。然而，美国的一些医疗中心不能迅速获得该水平的快速检测许可。因此，PLASMIC评分在启动即时治疗和预防危及生命的并发症方面变得至关重要。
