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St-Segment-Elevation Myocardial Infarction Unmasking Underlying Systemic Lupus Erythematosus or Representing Thrombotic Thrombocytopenic Purpura? Report of a Challenging Case Publisher



Ghodsi S1 ; Jenab Y1 ; Mohebi M1 ; Kamranzadeh H2 ; Mohammadi Z1
Authors
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Authors Affiliations
  1. 1. Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Tehran University Heart Center Published:2021


Abstract

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. © 2021 Tehran University of Medical Sciences.