Thrombotic thrombocytopenic purpura in a case of brucellosis.
Thrombotic thrombocytopenic purpura (TTP) is characterized by disseminated thrombotic occlusions located in the microcirculation and a syndrome of microangiopathic hemolytic anemia, thrombocytopenia, fever, and renal and neurologic abnormalities. Thrombotic thrombocytopenic purpura is encountered in a variety of clinical situations such as viral, bacterial, and mycobacterial infections, autoimmune disorders, drug reactions, connective tissue disease, and solid tumors. In this report, we present TTP in a case of brucellosis because of rare presentation. A 7-year-old girl was admitted with the complaints of headache, fever, hematuria, malaise, jaundice, epistaxis, and purpura. Her physical examination revealed conjunctival pallor, scleral icterus, petechial-purpuric skin lesions on both legs, and confusion. Laboratory tests showed hematocrit 14%; hemoglobin 4.8 g/dL; platelet count 6000/mm(3), and reticulocytosis 6%. Peripheral blood smear revealed fragmented red blood cells and a complete absence of platelets. The clinical and laboratory findings were consistent with TTP. Serum antibrucella titration agglutination test was found to be 1/1280 positive.
Akbayram
Sinan
S
Department of Pediatric Hematology, Yuzuncu Yil University, Van, Turkey. drsinanakbayram@gmail.com
Dogan
Murat
M
Peker
Erdal
E
Akgun
Cihangir
C
Oner
Ahmet Faik
AF
Caksen
Hüseyin
H
D002006:Brucellosis / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000628:therapy