Abstract
The thrombotic thrombocytopenic purpura (TTP) is not a common disease entity and presents multiple systemic symptoms, constellation of ambiguous GI complaints, fever, neurologic deficits and renal failure. As well as the mentioned symptoms, unexpected atypical symptoms related to small vessel occlusion could be complicated. In this case, multifocal cerebral infarction and non-territorial cardiac ischemia was noted. Surgery-related TTP is not common and needed to differentiate from surgery-related complications. We reported orthopedic surgery-related clinical vignette of TTP treated by plasmapheresis and the related literature would be reviewed.
Keywords: Thrombotic thrombocytopenic purpura; Cerebral infarction; Coronary artery; Plasmapheresis.
Fig. 1.
(A) MR findings of the first day of clinical deterioration. Multiple acute embolic infarction in left temporoparietal lobe and deep white matter. Old infarcted lesions were also denoted by DWI-FLAIR mismatch in bilateral temporoparietal lobe and left frontal lobe. The peak time of cerebral blood flow was prolonged at left temporoparietal lobe. (B) MR findings during plasmapheresis. Re-infarction at left temporoparietal lobe and new multiple embolic infarction at bilateral frontal, right temporoparietal, centrum semi-ovale, and left cerebellum.
DWI, diffusion-weighted image; ADC, apparent-diffusion coefficient; CT, computed tomography; FLAIR, fluid-attenuated inversion recovery; TTP, time to peak; MRA, magnetic resonance angiograph.
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