Article ID: 11332
We report a case of thrombotic thrombocytopenic purpura (TTP), which was diagnosed following an asymptomatic cerebral infarction and progressed rapidly to a fatal outcome. The patient was an 82-year-old woman with no significant medical history, who visited her previous doctor due to discomfort in her neck for the past three days. She was diagnosed with multiple scattered cerebral infarctions and transfer our hospital by herself. Although she has no obvious neurological deficits, head MRI in our hospital revealed embolic acute infarctions, and she was admitted for treatment. Upon hospitalization, blood tests showed thrombocytopenia, acute renal failure, and hemolytic anemia. The patient also became agitated, and it was determined that specialized treatment was necessary, leading to her transfer to another hospital. Subsequently, a decrease in ADAMTS13 activity was observed, leading to the diagnosis of TTP. Plasma exchange was performed as soon as possible, but the patient passed away the day after admission. The asymptomatic cerebral infarction was presumed to have been caused by microembolisms. TTP can present with only nonspecific symptoms and progress rapidly. Delayed treatment can lead to a fatal outcome, and therefore, careful attention is required.
