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Massive myocardial necrosis in thrombotic thrombocytopenic purpura: a case report and review of the literature



Massive myocardial necrosis in thrombotic thrombocytopenic purpura: a case report and review of the literature



Archives of Pathology & Laboratory Medicine 123(10): 937-940



Thrombotic thrombocytopenic purpura (TTP) is an uncommon syndrome resulting from diffuse occlusion of small arterioles and capillaries by hyaline microthrombi. It is characterized by fever, thrombocytopenic purpura, microangiopathic hemolytic anemia, and neurologic and renal dysfunction. While cardiac pathology in TTP is commonly seen at autopsy, clinical cardiac dysfunction is rare and typically results from conduction system involvement. While 3% to 8% of patients with TTP report chest pain on admission, reports of fatal ventricular pump failure are extremely rare. We now report a case of TTP resulting in death from widespread myocardial necrosis. This patient presented with elevated cardiac enzymes and electrocardiographic disturbances that mimicked viral myocarditis, as well as a profound thrombocytopenia. Such a case may represent the extreme of a distribution of cardiac involvement in TTP or the consequence of an unidentified autoimmune process capable of precipitating severe myocardial TTP.

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Accession: 010958700

Download citation: RISBibTeXText

PMID: 10506449

DOI: 10.1043/0003-9985(1999)123<0937:MMNITT>2.0.CO;2



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