Recurrent Strokes in a Woman with a History of Thrombotic Thrombocytopenic Purpura

Ijele Adimora; Bingnan Zhang; Modupe Idowu

doi:10.1155/2023/7070189

Recurrent Strokes in a Woman with a History of Thrombotic Thrombocytopenic Purpura

Case Rep Med. 2023 Aug 2:2023:7070189. doi: 10.1155/2023/7070189. eCollection 2023.

Authors

Ijele Adimora¹, Bingnan Zhang², Modupe Idowu³

Affiliations

¹ Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin St., Houston, TX 77030, USA.
² Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
³ Division of Hematology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin St., Houston, TX 77030, USA.

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a microangiopathy characterized by mechanical hemolytic anemia, resulting in end-organ damage. We describe a case of TTP which presented as an ischemic stroke. The patient presented with stroke as the primary manifestation of TTP despite a normal platelet count and mildly elevated lactate dehydrogenase level (LDH). The patient underwent two transfusions of fresh frozen plasma (FFP), and ADAMTS13 levels confirmed the diagnosis of TTP after discharge. This case demonstrates the importance of maintaining a high index of suspicion for TTP in the setting of normal laboratory values and reveals the many atypical manifestations of TTP.

Publication types

Case Reports