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非ST段抬高型心肌梗死作为血栓性血小板减少性紫癜的初始血栓事件:一例罕见的疑难病例

Non-ST-Segment Elevation Myocardial Infarction As Initial Thrombotic Event of Thrombotic Thrombocytopenic Purpura: A Rare Challenging Case.

作者信息

Mohamed Khalid H, Shiza Saher T, Samreen Iqra, Agboola Adesola A, Mohamed Alaa S, Kalluru Pavan Kumar Reddy, Haseeb Muhammad, Munawar Rana Zohaib, Nasir Hira

机构信息

Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR.

Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND.

出版信息

Cureus. 2023 Mar 19;15(3):e36363. doi: 10.7759/cureus.36363. eCollection 2023 Mar.

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare autoimmune and devastating blood disorder that results in micro-clots throughout the body, leading to tissue damage and organ dysfunction resulting in widespread microangiopathic hemolytic anemia, thrombocytopenia, fever, and neurological symptoms. TTP patients commonly manifest renal and neurological symptoms; however, cardiovascular involvement is not widely reported in the literature. We report a case of non-ST-segment elevation myocardial infarction (NSTEMI) as an initial manifestation of TTP. Although rare, TTP complications must be considered among other possible causes of unexpected thrombocytopenia during acute phase treatment of acute coronary syndrome because of high morbidity and mortality.

摘要

血栓性血小板减少性紫癜(TTP)是一种罕见的自身免疫性且具有破坏性的血液疾病,会在全身形成微血栓,导致组织损伤和器官功能障碍,进而引发广泛的微血管病性溶血性贫血、血小板减少、发热及神经症状。TTP患者通常会出现肾脏和神经症状;然而,心血管受累情况在文献中报道并不广泛。我们报告一例以非ST段抬高型心肌梗死(NSTEMI)为TTP首发表现的病例。尽管罕见,但在急性冠状动脉综合征急性期治疗期间,由于TTP并发症的高发病率和高死亡率,在考虑其他可能导致意外血小板减少的原因时,必须考虑到TTP并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f006/10112854/1438eb6fe14e/cureus-0015-00000036363-i01.jpg

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