title: Thrombotic thrombocytopenic purpura presenting with pathologic fracture: a case report.
abstract: Thrombotic thrombocytopenic purpura is an acute syndrome with abnormalities in multiple organ systems, which becomes manifest with microangiopathic hemolytic anemia and thrombocytopenia. The hereditary or acquired deficiency of ADAMTS-13 activity leads to an excess of high molecular weight von Willebrand factor multimers in plasma, leading to platelet aggregation and diffuse intravascular thrombus formation, resulting in thrombotic thrombocytopenic purpura. Thrombotic lesions occurring in TTP leads to ischemia and convulsion. Depending on the properties of the bony tissue, fractures are divided into three groups as traumatic, pathological, and stress fractures. A pathologic fracture is a broken bone caused by disease leading to weakness of the bone. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as cancer, infections, inherited bone disorders, or a bone cyst. We herein report a case with a pathologic fracture due to convulsion secondary to thrombotic thrombocytopenic pupura. Thrombotic lesions occurring in TTP may lead to ischemia and convulsion, as in our patient and pathological fractures presented in our case report may occur as a result of severe muscle contractions associated with convulsive activity. Thrombotic thrombocytopenic pupura is a disease that involves many organ systems and thus may have a very wide spectrum of clinical presentations.
authors.affiliation: Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: drilhamiberber@hotmail.com.
authors.forename: Ilhami
authors.initials: I
authors.lastname: Berber
authors.affiliation: Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Erkurt
authors.affiliation: Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Kuku
authors.affiliation: Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Kaya
authors.affiliation: Department of Radiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Unlu
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Ertem
authors.affiliation: Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Nizam
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D012640:Seizures / Q000150:complications / Q000000981:diagnostic imaging; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000209:etiology
keywords: Convulsion; Pathologic fracture; Thrombotic thrombocytopenic purpura