A dramatic recovery in a patient initially expected to die of TTP & its complications
Thrombotic thrombocytopenic purpura (TTP) has a high fatality rate if not caught early and treated with plasmapheresis. When TTP patients present late in their sequelae with neuro symptoms, an elevated lactate dehydrogenase and systemic symptoms, there is a high mortality rate. This report describes...
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| Format: | Article |
| Language: | English |
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Greater Baltimore Medical Center
2018-05-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20009666.2018.1475186 |
| _version_ | 1797967395646603264 |
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| author | Jennifer Ogilvie Jaskeerat Singh |
| author_facet | Jennifer Ogilvie Jaskeerat Singh |
| author_sort | Jennifer Ogilvie |
| collection | DOAJ |
| description | Thrombotic thrombocytopenic purpura (TTP) has a high fatality rate if not caught early and treated with plasmapheresis. When TTP patients present late in their sequelae with neuro symptoms, an elevated lactate dehydrogenase and systemic symptoms, there is a high mortality rate. This report describes the case of a young female who had no significant medical problems and presented to our hospital after several days of hematuria, new onset blurry vision and dizziness. She was found to have thrombocytopenia and microangiopathic hemolytic anemia consistent with TTP and was thus started on plasmapheresis. Her course was further complicated with seizures and development of bilateral basal ganglia infarcts which lead to the need for mechanical ventilation. This was followed by worsening renal functions which was managed with intermittent hemodialysis. To add to her multi-organ failure, she developed shock liver along with demand ischemia evidenced by significant elevations in liver enzymes and troponin leaks, respectively. However, on Day 4 it was fascinating to see the beginning of her recovery pathway. It began with response to simple commands followed by discontinuing invasive ventilation and gradual improvement in her renal functions evidenced by increasing urine output. Soon her platelets started rising consistently and she did not require plasmapheresis or hemodialysis by the time she was discharged. This case highlights the rapid recovery of a young female with new onset TTP which was complicated by involvement and severe damage of more than five different organs but was followed by complete recovery of each organ system. |
| first_indexed | 2024-04-11T02:30:34Z |
| format | Article |
| id | doaj.art-bb4268fe79e149d4838e98ff415f2d91 |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:30:34Z |
| publishDate | 2018-05-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-bb4268fe79e149d4838e98ff415f2d912023-01-02T21:41:06ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662018-05-018314214410.1080/20009666.2018.14751861475186A dramatic recovery in a patient initially expected to die of TTP & its complicationsJennifer Ogilvie0Jaskeerat Singh1MSIV Saba University SOMPGY3-IM, Greater Baltimore Medical CenterThrombotic thrombocytopenic purpura (TTP) has a high fatality rate if not caught early and treated with plasmapheresis. When TTP patients present late in their sequelae with neuro symptoms, an elevated lactate dehydrogenase and systemic symptoms, there is a high mortality rate. This report describes the case of a young female who had no significant medical problems and presented to our hospital after several days of hematuria, new onset blurry vision and dizziness. She was found to have thrombocytopenia and microangiopathic hemolytic anemia consistent with TTP and was thus started on plasmapheresis. Her course was further complicated with seizures and development of bilateral basal ganglia infarcts which lead to the need for mechanical ventilation. This was followed by worsening renal functions which was managed with intermittent hemodialysis. To add to her multi-organ failure, she developed shock liver along with demand ischemia evidenced by significant elevations in liver enzymes and troponin leaks, respectively. However, on Day 4 it was fascinating to see the beginning of her recovery pathway. It began with response to simple commands followed by discontinuing invasive ventilation and gradual improvement in her renal functions evidenced by increasing urine output. Soon her platelets started rising consistently and she did not require plasmapheresis or hemodialysis by the time she was discharged. This case highlights the rapid recovery of a young female with new onset TTP which was complicated by involvement and severe damage of more than five different organs but was followed by complete recovery of each organ system.http://dx.doi.org/10.1080/20009666.2018.1475186Thrombotic thrombocytopenic purpurarecoveryplasmapharesisrituximabgood responsemulti organ failure |
| spellingShingle | Jennifer Ogilvie Jaskeerat Singh A dramatic recovery in a patient initially expected to die of TTP & its complications Journal of Community Hospital Internal Medicine Perspectives Thrombotic thrombocytopenic purpura recovery plasmapharesis rituximab good response multi organ failure |
| title | A dramatic recovery in a patient initially expected to die of TTP & its complications |
| title_full | A dramatic recovery in a patient initially expected to die of TTP & its complications |
| title_fullStr | A dramatic recovery in a patient initially expected to die of TTP & its complications |
| title_full_unstemmed | A dramatic recovery in a patient initially expected to die of TTP & its complications |
| title_short | A dramatic recovery in a patient initially expected to die of TTP & its complications |
| title_sort | dramatic recovery in a patient initially expected to die of ttp its complications |
| topic | Thrombotic thrombocytopenic purpura recovery plasmapharesis rituximab good response multi organ failure |
| url | http://dx.doi.org/10.1080/20009666.2018.1475186 |
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