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首页> 外文期刊>Archives of neurology. >Renal failure and posterior reversible encephalopathy syndrome in patients with thrombotic thrombocytopenic purpura.
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Renal failure and posterior reversible encephalopathy syndrome in patients with thrombotic thrombocytopenic purpura.

机译：肾功能衰竭和后部可逆性脑病综合症患者血栓性血小板减少性紫癜。

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BACKGROUND: Little is known of the nature of the neurologic manifestations in thrombotic thrombocytopenic purpura (TTP). We have recently reported posterior reversible encephalopathy syndrome (PRES) as the predominant brain abnormality in patients with TTP. Posterior reversible encephalopathy syndrome has been associated with a variety of medications and pathologic states including increased arterial blood pressure and renal failure. The factors that predispose patients with TTP to PRES are not known. OBJECTIVES: To ascertain whether the presence and degree of hypertension and typical laboratory abnormalities seen in hospitalized patients with TTP are predictors of PRES. Design, Setting, and Patients We performed a retrospective analysis of brain imaging in 46 hospitalized patients with acute TTP seen at St Mary's and Rochester Methodist hospitals in Rochester, Minnesota, from January 1997 to June 2007. Head computed tomographic scans and brain magnetic resonance images were evaluated independently by 2 investigators. We then performed statistical analysis to determine whether the presence of PRES was associated with the presence of hypertension or abnormal laboratory data, including renal function. RESULTS: Forty-seven incidences of patients having TTP and neuroimaging were evaluated over a 10-year period. Thirty-three patients (70%) had brain magnetic resonance imaging performed. Of the patients who had acute abnormalities on brain magnetic resonance imaging, 13 (48%) were found to have PRES. Degree of hypertension was not associated with PRES on brain magnetic resonance imaging (P = .55). There was no association between hematocrit or platelet nadir, maximum blood urea nitrogen, D dimer, fibrinogen, lactate dehydrogenase, or total bilirubin levels and occurrence of PRES. The only variable highly associated with PRES on neuroimaging was the glomerular filtration rate (P = .02). CONCLUSION: The occurrence of PRES in patients with acute TTP is associated with worse renal function.
机译：背景:鲜为人知的性质神经系统表现在血栓性血小板减少性紫癜(TTP)。报道后部可逆性脑病综合征(总统)作为主要的大脑异常患者的TTP。可逆脑病综合征与各种药物和相关包括增加动脉病理状态高血压和肾功能衰竭。使患者TTP总统不是已知的。的存在和程度的高血压和典型实验室异常出现在住院患者TTP是总统的预测。设计,我们进行了设置,和病人回顾性分析脑成像的46岁住院病人急性TTP在圣玛丽的和罗切斯特卫理公会医院的明尼苏达州罗彻斯特从1997年1月到6月2007. 磁共振图像进行评估由2独立调查。执行统计分析来确定总统的存在是否相关高血压或异常的存在实验室数据,包括肾功能。结果:47个病人的发病率TTP和神经影像学评价10年的时期。脑磁共振成像表现。患者急性大脑异常磁共振成像,13个(48%)被发现总统。程度的高血压不是与总统在大脑核磁共振成像(P = 55)。比容或血小板最低点之间的最大值血尿素氮、D二聚体、纤维蛋白原、乳酸脱氢酶、总胆红素水平和发生的总统,唯一的变量高度与神经影像学是总统肾小球滤过率(P = .02点)。发生急性患者TTP的总统与肾功能恶化。

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