Successful Treatment of Thrombotic Thrombocytopenic Purpura with Recurrent Transient Ischemic Attacks in Old Age

ABSTRACT

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.