Sudden cardiac death from thrombotic thrombocytopenic purpura.
Clinical thrombotic thrombocytopenic purpura (TTP) is characterized by a pentad of microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, renal involvement, and fever. A case of TTP in which early symptoms and signs were suggestive of ischemic heart disease, renal failure, and severe thrombocytopenia developed to a rapid outcome of death. The postmortem examination revealed coronary artery microthrombi, typical of TTP. The clinical presentation of this TTP was atypical: severe thrombocytopenia, striking renal and CNS symptoms were present, but fever and anemia were not present. Thrombotic thrombocytopenic purpura is an uncommon condition that carries a high fatality rate if untreated. Awareness of this syndrome and its high risk of sudden death underlines the importance of rapid diagnosis and treatment.
Wajima
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T
Texas A&M University Health Science Center College of Medicine and Central Texas Veterans Health Care System, Temple 76504, USA. wajimaty@aol.com
Johnson
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EH
D003328:Coronary Thrombosis / Q000209:etiology / Q000473:pathology; D016757:Death, Sudden, Cardiac; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D020767:Intracranial Thrombosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis* / Q000473:pathology