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題名 | Sudden Cardiac Death in Thrombotic Thrombocytopenic Purpura--A Case Report and Review of the Literature=血栓性血小板低下紫斑症造成突發心臟性死亡--一病例報告及文獻回顧 |
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作者 | 吳明瑞; 方華章; 張子爰; 鍾孝民; | 書刊名 | 內科學誌 |
卷期 | 13:3 2002.06[民91.06] |
頁次 | 頁154-159 |
分類號 | 415.62 |
關鍵詞 | 血栓性血小板低下紫斑症; 突發心臟性死亡; Thrombotic thrombocytopenic purpura; Sudden cardiac death; Torsades de pointes; Hypocalcemia; Plasma exchange; |
語文 | 英文(English) |
中文摘要 | 性死亡的病例。此血栓性血小板低下紫斑症病例的臨床表現非常典型,包括血小板低下紫斑、發燒、神經受損及腎功能異常。入院後,診斷此症確定即刻施予血漿置換術治療。病人經過治療後情況沒有好轉,最後造成突發心臟性死亡。本文討論其造成心臟性死亡的原因,並參考之前文獻報告,發現血栓性血小板低下紫 斑症影響心臟器官乃其產生突發性死亡的合理解釋。另一方面,在施予血漿置換術治療期間產生的致命性心律不整,亦認為是一項促因。在瞭解血栓性血小板低下紫斑症產生突發心臟性死亡的高危險性及血漿置換術治療期間產生致命性心律不整的可能性之後,醫者應注重對此症的早期診斷、早期治療與施予血漿置換術治療期間的預防性處置。 |
英文摘要 | A 54-year-old man with thrombotic thrombocytopenic purpura (TTP) who developed sudden cardiac death is described. The clinical presentations of this case were typical including thrombocytopenic purpura, fever, neurologic deficit and renal abnormalities. On admission, plasma exchange was started soon after the diagnosis of TTP was made. Unfortunately, his condition deteriorated and went into a rapid outcome of death. The causes of mortality were discussed. We found that the reasonable cause of sudden death may be cardiac involvement of TTP. On the other hand, appearance of torsades de pointes during the therapy with plasma exchange could be considered as a contributing factor of his mortality. Understanding a high risk of sudden cardiac death in TTP and the possibility of lethal arrhythmia present in plasma exchange underlines the importance of early diagnosis, immediate treatment and prophylactic therapy in plasma exchange. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。