Pramanik Debolina, Bhardwaj Divyashish, Karmani Vikash K, Raval Girindra G, Kutlar Abdullah
Medicine, Medical College Kolkata, Kolkata, IND.
Medicine, Jawaharlal Nehru Medical College, Aligarh, IND.
Cureus. 2023 Jul 25;15(7):e42423. doi: 10.7759/cureus.42423. eCollection 2023 Jul.
We report a female patient who presented with generalized weakness, episodes of altered mental status and slurred speech, and a history of systemic lupus erythematosus. Initial investigations showed profound thrombocytopenia and schistocytosis on peripheral blood smear. PLASMIC score was promptly calculated, and plasma exchange with steroids was initiated based on the initial high PLASMIC score. Bone marrow examination showed hypocellular marrow without any other obvious abnormalities. The patient's platelet counts initially improved but had a quick decline, on which, rituximab and subsequently caplacizumab were introduced. The patient was discharged after stabilization with plasma exchange (PLEX) therapy as needed on an outpatient basis.
我们报告了一名女性患者，她出现全身无力、精神状态改变发作和言语不清，并有系统性红斑狼疮病史。初步检查显示外周血涂片有严重血小板减少和裂片红细胞。迅速计算了PLASMIC评分，并根据最初较高的PLASMIC评分开始进行血浆置换联合类固醇治疗。骨髓检查显示骨髓细胞减少，无任何其他明显异常。患者的血小板计数最初有所改善，但随后迅速下降，在此基础上，引入了利妥昔单抗，随后又使用了卡帕单抗。患者在门诊根据需要进行血浆置换（PLEX）治疗稳定后出院。
