Rare Presentation of Refractory Thrombotic Thrombocytopenic Purpura: Jejunal Stricture
AbstractThrombotic thrombocytopenic purpura is a rare thrombotic disease characterized by episodes of thrombocytopenia and microangiopathic hemolytic anemia due to disseminated microvascular thrombosis. Thrombotic thrombocytopenic purpura was first described in 1924 by Moschowitz as a disease presenting with a pentad of signs and symptoms (anemia, thrombocytopenia, fever, hemiparesis and hematuria). Previous studies have described atypical manifestations of thrombotic thrombocytopenic purpura such as hemolysis, anemia and thrombosis.
Moschcowitz E. Hyaline thrombosis of the terminal arterioles and capillaries: a hitherto undescribed disease. Proc N Y Pathol Soc; 1924; 24: 21-24.
George JN. How I treat patients with thrombotic thrombocytopenic purpura. Blood. 2010; 116(20):4060-4069.
Amorosi EL, Ultmann JE. Thrombotic thrombocytopenic purpura: report of the 16 cases and review of the literature. Medicine (Baltimore). 1966; 45: 139-159.
Carter D, Lang A, Eliakim R. Endoscopy in inflammatory bowel disease. Minerva Gastroenterol Dietol. 2013; 59(3): 273-84.
Buda A, Lamboglia F, Hatem G, et al. Evolving endoscopic technologies for the detection of dysplasia in inflammatory bowel diseases. Ann Ital Chir. 2011; 82(1):29-35.
Winwood PJ, Iredale JP, Williamson PJ, et al. Thrombotic thrombocytopenic purpura mimicking acute small bowel Crohn's disease. Gut. 1992; 33(6):857-9.
See JR, Sabagh T, Barde CJ. Thrombotic Thrombocytopenic Purpura: a case presenting with acute ischemic colitis. Case rep hematol. Case Rep Hematol. 2013; 2013: 592930.
Hellstrom HR, Nash EC, Fisher ER, et al. Thrombotic thrombocytopenic purpura as a cause of massive gastrointestinal hemorrhage; report of a case. Gastroenterology. 1959; 36(1):132-136.
Griffin D, Al-Nouri ZL, Muthurajah D, et al. First symptoms in patients with thrombotic thrombocytopenic purpura: what are they and when do they occur?. Transfusion. 2013. 53(1): 235–237.