Open AccessST-Segment-Elevation Myocardial Infarction Unmasking Underlying Systemic Lupus Erythematosus or Representing Thrombotic Thrombocytopenic Purpura? Report of a Challenging Case
Author(s) -
Saeed Ghodsi,
Yaser Jenab,
Mehrnaz Mohebi,
Hosein Kamranzadeh,
Zohre Mohammadi
Publication year - 2021
Publication title -
the journal of tehran university heart center./the journal of tehran university heart center
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.182
H-Index - 13
eISSN - 2008-2371
pISSN - 1735-8620
DOI - 10.18502/jthc.v16i2.7391
Subject(s) - thrombotic thrombocytopenic purpura , medicine , myocardial infarction , oliguria , percutaneous coronary intervention , cardiology , microangiopathic hemolytic anemia , acute kidney injury , plasmapheresis , systemic lupus erythematosus , hemolytic anemia , thrombocytopenic purpura , platelet , immunology , disease , antibody , renal function
Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder that frequently manifests itself with renal and neurological involvements. Cardiac involvement, however, has been rarely reported. In this report, we present a rare case of acquired TTP with acute myocardial infarction (AMI) as the initial manifestation. Although AMI was successfully managed by percutaneous coronary intervention, the patient developed hemolytic anemia, fever, marked thrombocytopenia, oliguria, and renal dysfunction, requiring treatment with plasma exchange and corticosteroids. TTP, albeit extremely rare, should be considered in cases with unexpected thrombocytopenia during acute-phase treatment for AMI as it can be highly lethal if not treated immediately.