Intracranial hemorrhage at the onset of thrombotic thrombocytopenic purpura in an infant: therapeutic approach and intensive care management.
Thrombotic thrombocytopenic purpura (TTP) is quite rare in infancy and must be treated intensively as a life-threatening disease. Diffuse vascular thromboses may occur, and neurologic involvement is a cornerstone of the diagnosis of TTP. We describe a case of an infant who presented with a sudden cerebral hemorrhage and subsequently developed the typical clinical features of TTP. Emergency treatment in the Pediatric Intensive Care Unit (PICU) consisted of plasma therapy and exchange-transfusion (EXT) to arrest the intravascular process and the exsanguinating blood loss. Exchange-transfusion is a life-saving procedure that is rarely performed after the neonatal age.
Department of Pediatrics, Catholic University, Rome, Italy. tipteam@yahoo.com
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Piastra
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Currò
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Chiaretti
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Viola
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Tortorolo
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Polidori
D003422:Critical Care / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods*; D017707:Erythrocyte Transfusion; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006454:Hemoglobins; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000209:etiology* / Q000628:therapy*; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D010314:Partial Thromboplastin Time; D010949:Plasma; D011517:Prothrombin Time; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000139:chemically induced / Q000150:complications* / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D006454:Hemoglobins; D005340:Fibrinogen