血小板减少性紫癜性心肌病和血浆置换肌钙蛋白清除:真或假的保证?

IF 0.8 Q4 PHARMACOLOGY & PHARMACY
Soomal Rafique, Yara Deeb, Fares Ghanem, Mukul Bhattarai
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引用次数: 0

摘要

血栓性血小板减少性紫癜(TTP)是一种罕见的微血管病溶血性贫血,由血管性血友病因子切割蛋白酶ADAMTS13的缺乏引起,导致微血栓的形成。TTP与严重的心血管并发症相关,如心肌梗死、充血性心力衰竭、心律失常和心源性休克,可导致预后不良。虽然血浆置换是TTP治疗的基石,但由于这些标志物从血液中迅速清除,它使心脏生物标志物的解释复杂化。我们提出的情况下,19岁的非洲裔美国女性诊断为TTP谁有高敏感肌钙蛋白(HS肌钙蛋白)的严重升高水平。值得注意的是,随着血浆置换术的进行,她的HS肌钙蛋白水平迅速下降,这强调了解释TTP中心脏生物标志物和治疗对这些值的影响的困难。本病例强调了TTP相关心血管并发症的诊断和管理的挑战及其对患者预后的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thrombotic Thrombocytopenic Purpura-Induced Cardiomyopathy and Troponin Clearance with Plasmapheresis: True or False Reassurance?

Thrombotic thrombocytopenic purpura (TTP) is a rare microangiopathic hemolytic anemia caused by a deficiency in the von Willebrand factor-cleaving protease ADAMTS13, resulting in the formation of microthrombi. TTP is associated with severe cardiovascular complications, such as myocardial infarction, congestive heart failure, arrhythmias, and cardiogenic shock, which can lead to a poor prognosis. Although plasmapheresis is the cornerstone of TTP treatment, it complicates the interpretation of cardiac biomarkers due to the rapid clearance of these markers from the bloodstream. We present the case of a 19-year-old African American female diagnosed with TTP who had critically elevated levels of high-sensitivity troponin (HS troponin). Notably, her HS troponin levels declined rapidly with ongoing plasmapheresis, underscoring the difficulties in interpreting cardiac biomarkers in TTP and the effects of treatment on these values. This case highlights the challenges in diagnosing and managing cardiovascular complications associated with TTP and their impact on patient prognosis.

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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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