You are here

Young Ischemic Stroke as Presentation of Thrombotic Thrombocytopenic Purpura: A Case Report

Journal Name:

Publication Year:

Abstract (2. Language): 
Thrombotic thrombocytopenic purpura (TTP) is a rare disorder with an estimated incidence of 3 - 7/1,000,000. It is an autoimmune disorder characterized by fever, neurological signs, microangiopathic hemolytic anemia, thrombocytopenia and renal failure. This case report will describe a young lady who presented with acute middle cerebral artery infarct and was subsequently diagnosed to have TTP. Therapeutic plasma exchange (TPE) did not improve the neurological deficit. This case highlights the importance of recognizing TTP as a possible differential diagnosis in young onset stroke.
121
124

REFERENCES

References: 

[1] Van der Worp, H. Bart, and Jan van Gijn. “Acute ischemic stroke.” New England Journal of Medicine Vol. 357,
No. 6, 2007, pp. 572-79.
[2] Feigin, Valery L., et al. “Stroke epidemiology: a review of population-based studies of incidence, prevalence, and
case-fatality in the late 20th century.” The Lancet Neurology Vol. 2, No. 1, 2003, pp. 43-53.
[3] Moake, Joel L. “Thrombotic thrombocytopenic purpura: the systemic clumping “plague”.” Annual Review of
Medicine Vol. 53, No. 1, 2002, pp. 75-88.
[4] George, James N., et al. “Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: Diagnosis and
management.” Journal of Clinical Apheresis Vol. 13, No. 3, 1998, pp. 120-25.
Azmi, et al. Int J Med Res Health Sci 2017, 6(12): 121-124
124
[5] Meloni, Giovanna, et al. “Thrombotic thrombocytopenic purpura: prospective neurologic, neuroimaging and
neurophysiologic evaluation.” Haematologica Vol. 86, No. 11, 2001, pp. 1194-99.
[6] Gruber, Oliver, et al. “Thrombotic thrombocytopenic purpura: MRI demonstration of persistent small cerebral
infarcts after clinical recovery.” Neuroradiology Vol. 42, No. 8, 2000, pp. 616-18.
[7] Tardy, B., et al. “Thrombotic thrombocytopenic purpura: MR findings.” American Journal of Neuroradiology Vol.
14, No. 2, 1993, pp. 489-90.
[8] Scheid, Rainer, et al. “Major stroke in thrombotic-thrombocytopenic purpura (Moschcowitz
syndrome).” Cerebrovascular Diseases Vol. 18, No. 1, 2004, pp. 83-85.
[9] Rinkel, G. J., E. F. Wijdicks, and Ronald J. Hené. “Stroke in relapsing thrombotic thrombocytopenic
purpura.” Stroke Vol. 22, No. 8, 1991, pp. 1087-89.
[10] Wijdicks, Eelco Fm. “Silent brain infarct in thrombotic thrombocytopenic purpura.” Stroke Vol. 25, No. 6, 1994,
pp. 1297-98.
[11] Kelly, P. J., et al. “Middle cerebral artery main stem thrombosis in two siblings with familial thrombotic
thrombocytopenic purpura.” Neurology Vol. 50, No. 4, 1998, pp. 1157-60.
[12] Boattini, Matteo, and Gaetano Procaccianti. “Stroke due to typical thrombotic thrombocytopenic purpura treated
successfully with intravenous thrombolysis and therapeutic plasma exchange.” BMJ Case Reports Vol. 2013,
2013, p. bcr2012008426.
[13] Downes, Katharine A., et al. “Relapsed thrombotic thrombocytopenic purpura presenting as an acute
cerebrovascular accident.” Journal of Clinical Apheresis Vol. 19, No. 2, 2004, pp. 86-89.
[14] Zheng, X. Long, et al. “Effect of plasma exchange on plasma ADAMTS13 metalloprotease activity, inhibitor
level, and clinical outcome in patients with idiopathic and nonidiopathic thrombotic thrombocytopenic
purpura.” Blood Vol. 103, No. 11, 2004, pp. 4043-49.
[15] Ozdogu, Hakan, et al. “A dramatic response to rituximab in a patient with resistant thrombotic thrombocytopenic
purpura (TTP) who developed acute stroke.” Journal of Thrombosis and Thrombolysis Vol. 23, No. 2, 2007, pp.
147-50.
[16] George, James N., et al. “Rituximab therapy for thrombotic thrombocytopenic purpura: A proposed study of
the Transfusion Medicine/Hemostasis Clinical Trials Network with a systematic review of rituximab therapy for
immune-mediated disorders.” Journal of Clinical Apheresis Vol. 21, No. 1, 2006, pp. 49-56.
[17] Tsai, Han-Mou, and Keith Shulman. “Rituximab induces remission of cerebral ischemia caused by thrombotic
thrombocytopenic purpura.” European Journal of Haematology Vol. 70, No. 3, 2003, pp. 183-85.

Thank you for copying data from http://www.arastirmax.com