Púrpura trombótica trombocitopénica: importancia del trabajo multidisciplinar

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a medical emergency with life-threatening complications. It presents itself as a diagnostic challenge, as it involves multiple organs affected by widespread microthrombosis that can rapidly cause severe ischemic impairment. Early recognition and treatment are crucial. Treatment includes prompt initiation of plasma exchange (PEX), immunosuppressive therapy, and caplacizumab, along with close monitoring of clinical signs, especially brain and cardiac function.

We present a case report with a witnessed cardiac arrest, in which the extracorporeal cardiopulmonary resuscitation (ECPR) protocol was performed, and the first dose of intra-arrest caplacizumab together with plasma infusion, were administered due to the suspected diagnosis of TTP. The first PEX session was done within the first three hours after cardiac arrest. Despite thrombocytopenia and anemia, the cannulation of the ECMO device was achieved in less than 40 min. The patient's evolution was favorable with minimal neurological sequelae and cardiac function recovery.