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Journal of the Korean Geriatrics Society 2008;12(4):251-254.
Published online December 31, 2008.
Successful Treatment of Thrombotic Thrombocytopenic Purpura with Recurrent Transient Ischemic Attacks in Old Age
Bon D Ku, Hye Yoon Kim
고령에서 일과성 허혈발작을 반복적으로 보인 혈전성 혈소판 감소성 자반증의 성공적 치험 1예
Thrombotic thrombocytopenic purpura(TTP) is an uncommon fatal disorder of young adults characterized by thrombocytopenia, microangiopathic hemolytic anemia, fluctuating neurologic dysfunction, fever, and renal dysfunction. The fluctuating neurologic dysfunction, which is mainly due to small arteriolar or capillary ischemic vasculopathy, suggests impending stroke. We report a 72-year-old woman who has had recurrent and progressive transient ischemic attacks and confusion after a large amount of bloodletting. She recovered completely after intensive plasmapheresis and immunosuppressant treatment. This case illustrates that aggressive treatment, even in old age, may prevent permanent neurologic deficits when stroke is impending and complicated by TTP.
Key Words: Thrombocytopenic thrombotic purpura, Transient ischemic attack, Plasmapheresis
초 록

본 증례는 고령에서 반복적인 신경학적 증상을 보인 TTP를 적극적인 혈장분리 교환술 및 면억 억제요법으로 성공적으로 치험한 증례이다. 혈장분리 교환술이 이 질환의 근본적인 치료법 임을 고려하면 고령 및 변동성이 심한 신경학적 증상 시에 수반될 수 있는 혈장분리 교환술의 위험성에도 불구하고, 적극적인 혈장분리 교환술을 시행하는 것이 도움이 될 것으로 생각된다.

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