Sturgess A D, Chong B H
Scand J Haematol. 1986 Oct;37(4):319-22. doi: 10.1111/j.1600-0609.1986.tb02320.x.
A 60-yr-old female presented with typical thrombotic thrombocytopenic purpura (TTP). She remained in coma with frequent seizures for 1 wk, with persisting severe thrombocytopenia and microangiopathic haemolytic anaemia, despite treatment with prednisolone, plasma exchange, fresh frozen plasma, sulphinpyrazone and dipyridamole. Splenectomy induced haematological improvement within 1 d, there was cessation of fitting after 2 d, and full neurological recovery ensued over 3 wk. Laboratory studies did not reveal the presence of a platelet-aggregating factor (PAF), stated to be present in some two-thirds of cases. While plasma exchange and plasma infusion are beneficial in many cases, splenectomy appears still to be of value in unresponsive disease.
一名60岁女性表现出典型的血栓性血小板减少性紫癜（TTP）。尽管接受了泼尼松龙、血浆置换、新鲜冷冻血浆、磺吡酮和双嘧达莫治疗，但她仍昏迷1周，频繁癫痫发作，持续存在严重血小板减少和微血管病性溶血性贫血。脾切除术后1天内血液学状况得到改善，2天后癫痫发作停止，3周内神经功能完全恢复。实验室检查未发现血小板聚集因子（PAF）的存在，据说约三分之二的病例中存在该因子。虽然血浆置换和血浆输注在许多病例中有益，但脾切除术对于难治性疾病似乎仍有价值。
