作为肺结核临床表现的获得性血栓性血小板减少性紫癜:病例报告。

IF 1.7 Q3 INFECTIOUS DISEASES GERMS Pub Date : 2023-09-30 eCollection Date: 2023-09-01 DOI:10.18683/germs.2023.1392
Kateir Contreras, Oscar Miguel Contreras Amorocho, Julian Serrano Giraldo
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引用次数: 0

摘要

导言:血栓性血小板减少性紫癜(TTP)是一种血栓性微血管病,与严重的 ADAMTS13 缺乏症有关,如不及时治疗可能致命:一名 49 岁的健康女性因 3 个月的胸腹部疼痛和头痛病史入院,伴有食欲不振、呕吐、夜间腹泻,体重意外减少 10 公斤。入院时,她出现贫血、血小板减少、外周血涂片中出现裂形细胞,ADAMTS13检出率为1.4%。根据实验室检查结果,她被确诊为 TTP,并开始接受血浆置换治疗和类固醇脉冲治疗,血液学改变有所缓解。在确定 TTP 病因的研究中,发现了肺结核(TB),排除了肿瘤和自身免疫性病变。在开始接受四联疗法治疗后,患者的耐受性达到最佳:结论:临床怀疑 TTP 时,应立即开始血浆置换治疗;感染、肿瘤或自身免疫性病变都可能是诱因;在本例病例中,肺结核得到了证实。
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Acquired thrombotic thrombocytopenic purpura as a clinical manifestation of pulmonary tuberculosis: a case report.

Introduction: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy associated with severe ADAMTS13 deficiency that can be potentially fatal if not treated in a timely manner.

Case report: A 49-year-old previously healthy woman was admitted with a 3-month history of thoracoabdominal pain and headache associated with loss of appetite, emesis, nocturnal diaphoresis, and unintentional loss of 10 kg. On admission she presented anemia, thrombocytopenia, schistocytes in peripheral blood smear, and ADAMTS13 in 1.4%. Due to laboratory findings a diagnosis of TTP was established, and plasma exchange therapy and steroid pulses were started, with resolution of hematological alterations. Within the studies to determine etiology of TTP, pulmonary tuberculosis (TB) was found, neoplastic and autoimmune pathologies were excluded. The tetraconjugated treatment was initiated with optimal tolerance.

Conclusions: Upon clinical suspicion of TTP, plasma exchange therapy should be initiated urgently; infectious, neoplastic, or autoimmune pathologies can be triggers; in this case, pulmonary TB was confirmed.

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来源期刊
GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
自引率
5.00%
发文量
36
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