Atypical clinical presentation of thrombotic thrombocytopenic purpura just after percutaneous coronary intervention

Abstract

    Thrombotic thrombocytopenic purpura (TTP) is a life-threatening illness associated with cardiovascular surgery, infection and medications. We report a case of a 77-year-old female patient with acute myocardial infarction (AMI) treated with percutaneous coronary intervention and suffered TTP immediately afterwards. This was successfully treated with plasma exchanges. Differential diagnosis of the thrombocytopenia was important and assays for the activities of von Willebrand Factor-cleaving protease, its inhibitor and heparin-induced thrombocytopenia (HIT) antibody were helpful to differentiate TTP from other conditions, including HIT and disseminated intravascular coagulation. Intensivists should be aware of an atypical presentation of TTP associated with AMI.