医学
血栓性血小板减少性紫癜
全血细胞减少症
弥漫性血管内凝血
血栓性微血管病
微血管病性溶血性贫血
ADAMTS13号
急性白血病
髓系白血病
分裂细胞
内科学
血小板减少性紫癜
胃肠病学
白血病
骨髓
血小板
疾病
作者
Ijele Adimora,Cristhiam M. Rojas‐Hernandez
出处
期刊:American Journal of Case Reports
[International Scientific Information, Inc.]
日期:2022-07-28
卷期号:23
被引量:1
摘要
BACKGROUND Acute myeloid leukemia (AML) is a myeloid progenitor malignancy characterized by clonal expansion of immature blasts. Complications of AML can result from disease-related or treatment-related complications and commonly include bleeding and disseminated intravascular coagulation. Thrombotic thrombocytopenic purpura (TTP) is a microangiopathy syndrome characterized by a mechanical hemolytic anemia and a consumptive thrombocytopenia resulting in end-organ damage from thrombotic occlusion of small vessels. CASE REPORT We describe a case of TTP at our institution that developed after diagnosis of AML, an exceedingly rare phenomenon with only one such documented case in the current literature. We were advised to see this patient after development of renal failure and encephalopathy. Suspicion for TTP was initially low, as our patient had a low pre-test probability of TTP by the PLASMIC score. Our patient was treated for disseminated intravascular coagulopathy, without response. Plasma exchange pheresis (PLEX) was eventually begun 3 days after presentation upon result of ADAMTS13 activity at 10%, with presence of inhibitor. ADAMTS13 activity levels were used to guide continuation of PLEX, given our patient's persistent pancytopenia. CONCLUSIONS Our case demonstrates the challenges of identifying and managing TTP in patients with concomitant hematologic malignancies. ADAMTS13 activity levels should be collected in patients presenting with evidence of hemolytic anemia, even if the pre-test probability of TTP is low.
科研通智能强力驱动
Strongly Powered by AbleSci AI