Thrombotic Thrombocytopenic Purpura: A Case Presenting with Acute Ischemic Colitis

Abstract

Thrombotic thrombocytopenic purpura (TTP) consists of the pentad of thrombocytopenia, hemolytic anemia, fever, neurologic abnormalities, and renal disease. We present a case report of acute TTP following a bout of ischemic colitis. This report reminds the clinician that ischemic colitis can be an atypical presentation of TTP. The prompt recognition and treatment of this disease process resulted in a good prognosis for our patient.

A case of refractory thrombotic thrombocytopenic purpura treated with plasmapheresis and rituximab

“…[17] Long-term consequences of TTP are not well known, but it has been postulated that some patients may go on to develop longterm renal dysfunction and neurocognitive deficits. [15] This case report demonstrates both the poss ibilities and challenges of managing TTP. Diagnosis and initiation of appropriate therapy according to international guidelines was possible for this patient and a relatively good response was demonstrated.…”

“…PEX also replaces the missing von Willebrand cleav ing protease. [15] Although the mortality of TTP has been reduced in most European countries and in America, we postulate that TTP still has a high mortality in SSA owing to lack of PEX. Management of refractory TTP is a bigger challenge owing to the need for more prolonged duration of treatment.…”

Metis, migrants, and the autonomy of migration

“…Incidentally, the evidence for extensive institutional entanglement comes from not only the various strategies employed by the Paper Sons/ Daughters, but also the extreme level of corruption and bribery involved in numerous cases and implicating immigration officers, lawyers, and guards. 22 Indeed, for all its oppressive power -detentions, interrogations, and exclusionary laws -the institution of immigration was pushed to the edge, unable to function: a Homeric Cyclops who removes the stone blocking the entrance and stretches his arms opened in an attempt to capture 'nobody' -a fictitious identity. The immigration institution was caught within the web of its own undoing, caught up in a self-generated vicious cycle: first, the Paper Sons/Daughters were capable of making citizenship claims because the legal system had made an allowance for such claims.…”