TUhjnbcbe - 2021/6/27 3:39:00
COVID19infectionassociatedwiththromboticthrombocytopenicpurpuraJThromb?ThrombolysisArticleEarlyRecent,Apr27,./s---0本文由“天纳”临床学术信息人工智能系统自动翻译点击文末“阅读原文”下载本文PDFThromboticthrombocytopenicpurpura(TTP)whichcancausesignificantmortalityisathromboticmicroangiopathyduetodeficiencyofVWFcleavingproteaseADAMTS13andaspermedicalliteraturethereareexamplesthatTTPcanbecausedbyCOVID19infection.A35?yearsoldfemaleafteradmissionwithrightsidedweaknessandslurringofspeechwasfoundtobeCOVIDpositiveanddiagnosedasacaseofTTP.PatienthadabsentADAMTS13levelonday1.Treatmentwasstartedwiththerapeuticplasmaexchange(TPE)laterinjectionVincristineandRituximabwasgivenafter4thTPEasitwassuspectedasrefractorycase.Finallypatientreceived16TPEprocedureswithcryopoorplasmaasexchangefluidandgraduallyherplateletcountstartedtomaintainnormalandshewasdischarged.Specificmanagementandsuchassociationofthistypeofcasesneedtobestudiedmorejudiciously.血栓性血小板减少性紫癜（TTP）是由于VWF裂解蛋白酶ADAMTS13缺乏引起的血栓性微血管病，可导致显著的死亡率，根据医学文献，TTP可由COVID19感染引起。35岁?岁女性，入院后右侧无力，口齿不清，COVID阳性，诊断为TTP。患者在第1天没有ADAMTS13水平。治疗开始于治疗性血浆置换（TPE），怀疑为难治性病例，第4次TPE后注射长春新碱和利妥昔单抗。最后患者接受了16次TPE治疗，以低温血浆为交换液，血小板计数逐渐恢复正常，出院。需要更明智地研究这类案件的具体管理和这种联系。AttheendofDecembersevereacuterespiratorysyndromecoronavirus2(SARS-CoV-2/COVID-19)relatedcasesemergedandinFebruary,WHOdeclareditasaPandemic[1].AspermedicalliteratureitisevidentthatCOVID19casesmayshowmultipleimmunologicalphenomenonlikeImmunethrombocytopenicpurpura,Guillain-Barrésyndromeandantiphospholipidsyndrome,autoimmunehaemolyticanaemia,Thromboticthrombocytopenicpurpura(TTP)[2,3,4,5,6].TTPisathromboticmicroangiopathy,mainlydefinedbythepentadoffever,renaldysfunction,hemolyticanemia,thrombocytopenia,centralnervoussystem(CNS)involvementduetodeficiencyofVWFcleavingproteaseADAMTS13.TTPrequiretobeaccuratelydiagnosedandpromptlyintervenedotherwisepatientcanhavemortalityrateupto90%.年12月底，出现了严重急性呼吸综合征冠状病*2型（SARS-CoV-2/COVID-19）相关病例，并于年2月，世卫组织宣布其为大流行[1]。根据医学文献，covid19例可能表现出多种免疫现象，如免疫性血小板减少性紫癜、Guillain-Barré综合征和抗磷脂综合征、自身免疫性溶血性贫血、血栓性血小板减少性紫癜（TTP）[2,3,4,5,6]。TTP是一种血栓性微血管病，主要表现为VWF裂解蛋白酶ADAMTS13缺乏引起的发热、肾功能不全、溶血性贫血、血小板减少、中枢神经系统（CNS）受累。TTP需要准确诊断和及时干预，否则死亡率可达90%。Wereportacaseof35?yearsoldfemalepatientwithoutany