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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Incidental Thrombotic Thrombocytopenic Purpura during Acute Ischemic Stroke and Thrombolytic Treatment
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Incidental Thrombotic Thrombocytopenic Purpura during Acute Ischemic Stroke and Thrombolytic Treatment

机译：急性缺血性中风和溶栓治疗期间偶然血栓形成血小板细胞紫癜

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Background: Intravenous tissue plasminogen activator (IV tPA) was shown to be an effective treatment for acute ischemic stroke (AIS). According to stroke guidelines, there is no need to wait for the complete blood count (CBC) and coagulation test results before application of IV alteplase if there is no suspected coagulation disorder. In this study, a patient with AIS and thrombotic thrombocytopenic purpura (TTP) symptoms during thrombolytic treatment was presented. Case: A 33-year-old male patient was admitted at the 2.5th hour of AIS symptoms onset with right hemiparesis and sensorimotor aphasia. Cranial computed tomography (CT) and diffusion magnetic resonance imaging did not reveal any abnormality. In his medical history, the patient did not have any contraindication for thrombolytic treatment. To avoid delays to thrombolytic therapy, blood samples were taken, and after that, IV bolus alteplase treatment was applied. During maintenance treatment, agitation and vomiting developed. The result of blood samples showed less than 26,000 mm(3) platelet count and maintenance therapy was stopped. In control cranial CT, there was no hemorrhage. In the laboratory examination; anemia, low platelet count; increased indirect bilirubin, lactate dehydrogenase (LDH) levels were found, and fever was 38.4 degrees C. Schistocytes were observed in peripheral blood smear and the patient was diagnosed as TTP. Conclusions: Stroke guidelines recommend not to wait for the results of CBC and coagulation tests before IV tPA treatment in patients who do not have any history of coagulopathy disorder. If possible, before applying IV tPA we may wait for the results of coagulation and CBC tests, keeping in mind the diseaes with high mortality such as TTP. (c) 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：静脉内组织纤溶酶原激活剂（IV TPA）被证明是急性缺血性卒中（AIS）的有效处理。根据中风准则，如果没有疑似凝血障碍，则无需等待完整的血统计数（CBC）和凝固测试结果。在本研究中，提出了具有AIS和血栓形成血小板减少紫癜（TTP）溶栓治疗症状的患者。案例：33岁的男性患者在患有正确的偏瘫和感官运动症的症状的症状的2.5小时内被录取。颅骨计算机断层扫描（CT）和扩散磁共振成像未透露任何异常。在他的病史中，患者对溶栓治疗没有任何禁忌症。为了避免延迟溶栓治疗，采集血液样品，然后施加静脉溶剂酶处理。在维护治疗期间，发育搅拌和呕吐。血液样品的结果显示出小于26,000 mm（3）血小板计数和维持治疗。在控制颅Ct中，没有出血。在实验室检查;贫血，低血小板计数;增加间接胆红素，发现乳酸脱氢酶（LDH）水平，发热为38.4℃，在外周血涂片中观察到血小细胞，患者被诊断为TTP。结论：中风指南建议不要等待在没有任何凝血病症疾病历史历史的IV TPA治疗之前等待CBC和凝血试验的结果。如果可能的话，在申请IV TPA之前，我们可能等待凝血和CBC测试的结果，并记住患有高死亡率的伤害，如TTP。 （c）2018国家冲程协会。由elsevier Inc.保留所有权利发布。

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