Thrombotic thrombocytopenic purpura with reversible splenial lesion syndrome: a case report

• Main Authors: Song Hu, Xinyue Hou, Shuhao Liu, Chunxiao Fei, Lingyan Zhou, Ang Xing, Junqing Zhang, Chunming Yong, Xiaomeng Wang
• Format: Article
• Language: English
• Published: BMC 2020-04-01
• Series: BMC Neurology
• Subjects: Thrombotic thrombocytopenic purpura; Reversible splenial lesion syndrome; Hemolytic uremic syndrome
• Online Access: http://link.springer.com/article/10.1186/s12883-020-01696-2

Abstract Background Reversible splenial lesion syndrome (RESLES) is known to cause severe psychiatric symptoms but is also a very rare clinical disease in which the specific aetiology is unknown. According to current reports, there are major causes of the disease, including viral or bacterial infection, epilepsy, anti-epileptic drug withdrawal, high-altitude cerebral oedema, and metabolic disorders such as hypoglycaemia and hypernatraemia. In this article, we report a patient with thrombotic thrombocytopenic purpura (TTP) who presented with RESLES. Case presentation A 34-year-old female patient who presented with fever and progression of disorder of consciousness was eventually diagnosed with RESLES based on brain imaging. Moreover, clinical features and peripheral smears demonstrating schistocytes and thrombocytopenia confirmed a diagnosis of TTP. RESLES can be improved by plasma exchange therapy. Conclusion This rare case highlights the occurrence of RESLES as a presenting feature of the expanding list of unusual neurological manifestations of TTP.