本文报道了1例以神经功能受损为主诉的血栓性血小板减少性紫癜患者的诊治过程。该患者男性65岁,急性起病,症状表现为失语、肢体麻木及无力,症状波动而多变,并伴有发热。血液学检查发现贫血、血小板计数下降;有轻度肾功能受损;外周血涂片见红细胞碎片;血浆ADAMTS13活性显著降低,ADAMTS13抑制物阳性。该例患者被诊断为特发性血栓性血小板减少性紫癜,经及时诊断及积极进行血浆置换治疗后,病情得以缓解。
Abstract
This paper reports the diagnosis and management of a 65-year-old male patient with thrombotic thrombocytopenic purpura (TTP) presenting with neurological symptoms. The onset of the disease was sudden, presenting with cerebral manifestations including aphasia, limb numb and weakness. The symptoms observed were variable and fluctuant. After admission, this patient had a fever. The laboratory examination revealed anemia, peripheral thrombocytopenia, moderate renal involvement, schistocytosis, a severe functional deficiency in ADAMTS13 and positive anti-ADAMTS13 antibodies. Clinical and biological anomalies ascertained the diagnosis of idiopathic TTP. With the rapid diagnosis and therapeutical plasma exchange immediately performed, the patient reached a complete recovery.
关键词
血栓性血小板减少性紫癜 /
血小板减少 /
贫血 /
神经症状
Key words
Thrombotic thrombocytopenic purpura /
Thrombocytopenia /
Anemia /
Neurological symptoms
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