An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review
Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy with an estimated incidence of 11 cases/million population per year. Early treatment is essential and is curative in this disease where lack of treatment results in 90% mortality. We describe an atypical case of a patient...
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Wolters Kluwer Medknow Publications
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doaj-56362ca89f8e4ba9a2a99cb7387b604a2020-11-24T20:58:29ZengWolters Kluwer Medknow PublicationsJournal of Acute Disease2221-61892014-01-013215716010.1016/S2221-6189(14)60034-2An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature reviewShafeek KiblawiElie HarmoucheRalph Bou CheblGilbert Abou DagherThrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy with an estimated incidence of 11 cases/million population per year. Early treatment is essential and is curative in this disease where lack of treatment results in 90% mortality. We describe an atypical case of a patient with TTP who presented to the Emergency Department for headache, and was found to have thrombocytopenia but only mild anemia that was explained by another disease process. Case: A 44-year-old female presented to the Emergency Department for worsening headache and weakness over the last week. She had no fever and no focal neurological deficits but was pale and complained of severe headache. A blood test showed her to be anemic and thrombocytopenic. She explained that she had been having prolonged heavy menses over the last year. She was treated with blood and platelet transfusions, and seen by the Gynecology service who treated her for uterine fibroids after which she was discharged. She returned 1 week later with the same complaint, and was found to have a stable hemoglobin level but recurrence of thrombocytopenia. A TTP diagnosis was entertained and the workup confirmed it. The patient was treated with plasmapheresis and discharged home with no sequalae. Conclusion: Emergency physicians should keep TTP in mind when approaching cases of thrombocytopenia with mild anemia, even if an alternative diagnosis exists.http://www.sciencedirect.com/science/article/pii/S2221618914600342Thrombotic thrombocytopenic purpuraThrombotic microangiopathyTTPAtypical |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shafeek Kiblawi Elie Harmouche Ralph Bou Chebl Gilbert Abou Dagher |
spellingShingle |
Shafeek Kiblawi Elie Harmouche Ralph Bou Chebl Gilbert Abou Dagher An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review Journal of Acute Disease Thrombotic thrombocytopenic purpura Thrombotic microangiopathy TTP Atypical |
author_facet |
Shafeek Kiblawi Elie Harmouche Ralph Bou Chebl Gilbert Abou Dagher |
author_sort |
Shafeek Kiblawi |
title |
An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review |
title_short |
An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review |
title_full |
An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review |
title_fullStr |
An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review |
title_full_unstemmed |
An insidious presentation of thrombotic thrombocytopenic purpura: A case report and brief literature review |
title_sort |
insidious presentation of thrombotic thrombocytopenic purpura: a case report and brief literature review |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Acute Disease |
issn |
2221-6189 |
publishDate |
2014-01-01 |
description |
Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy with an estimated incidence of 11 cases/million population per year. Early treatment is essential and is curative in this disease where lack of treatment results in 90% mortality. We describe an atypical case of a patient with TTP who presented to the Emergency Department for headache, and was found to have thrombocytopenia but only mild anemia that was explained by another disease process. Case: A 44-year-old female presented to the Emergency Department for worsening headache and weakness over the last week. She had no fever and no focal neurological deficits but was pale and complained of severe headache. A blood test showed her to be anemic and thrombocytopenic. She explained that she had been having prolonged heavy menses over the last year. She was treated with blood and platelet transfusions, and seen by the Gynecology service who treated her for uterine fibroids after which she was discharged. She returned 1 week later with the same complaint, and was found to have a stable hemoglobin level but recurrence of thrombocytopenia. A TTP diagnosis was entertained and the workup confirmed it. The patient was treated with plasmapheresis and discharged home with no sequalae. Conclusion: Emergency physicians should keep TTP in mind when approaching cases of thrombocytopenia with mild anemia, even if an alternative diagnosis exists. |
topic |
Thrombotic thrombocytopenic purpura Thrombotic microangiopathy TTP Atypical |
url |
http://www.sciencedirect.com/science/article/pii/S2221618914600342 |
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