Abstract
We describe 5 cases of thrombotic thrombocytopenic purpura (TTP) with neurological manifestations. All of the patients underwent brain magnetic resonance imaging (MRI) following recovery; two underwent single photon emission tomography (SPET) during the acute phase of the disease. SPET showed reduced cerebral blood flow, whereas the results of brain MRI were normal in all patients. Plasma exchange (PE) treatment was promptly instituted in all cases.
Our findings show that prompt treatment with PE may avoid permanent brain damage even when the neurological signs and symptoms are relate to brain ischemia.
Sommario
Descriviamo 5 casi di Porpora Trombotica Trombocitopenica con manifestazioni neurologiche. Tutti i casi sono stati studiati mediante Risonanza Magnetica Cerebrale dopo la regressione della sintomatologia neurologica. Durante la fase acuta della malattia, due di loro sono stati studiati anche con SPET cerebrale. La SPET ha mostrato una riduzione del flusso ematico cerebrale mentre la Risonanza Magnetica è risultata normale in tutti i pazienti. Il trattamento con plasmaferesi veniva iniziato rapidamente in tutti i casi.
I nostri dati indicano che un repentino trattamento con plasmaferesi può evitare un danno neurologico permanente, sebbene i segni ed i sintomi siano ascrivibili all'ischemia cerebrale.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ben-Yehuda D., Rose M., Michaeli Y., Eldor A.:Permanent neurological complications in patients with thrombotic thrombocytopenic purpura. Amer. J. Hemat. 29:74–78, 1988.
Chosey M.S., Costa D.C., Iannotti I., Ell P., Crockard H.A.:99mTc-HMPAO SPET and cerebral blood flow: a study of CO 2 reactivity. Nucl. Med. Commun. 10:609–618, 1989.
D'Aprile P., Farchi G., Pagliarulo R., Carella A.:Thrombotic thrombocytopenic purpura: MR demonstration of reversible brain abnormalities. AJNR 15:19–20, 1994.
De la Sayette V.:Purpura Thrombotique Thrombocytopénique. I cas avec Imagerie par Résonance Magnétique. Rev. Neurol. 147 (4):314–317, 1991.
Kay A.C., Solberg Jr. L.A., Douglas A.N., Petitt R.M.:Prognostic significance of computed tomography of the brain in thrombotic thrombocytopenic purpura. Mayo Clin. Proc. 66 (6):602–607, 1991.
Silverstein A.:Thrombotic thrombocytopenic purpura. The initial neurologic manifestations. Arch. Neurol. 18:358–362, 1968.
Tardy B., Page Y., Convers P., Mismetti P., Barral F., Bertrand J.C.:Thrombotic thrombocytopenic purpura MR findings. AJNR 14:489–490, 1993.
Vianelli N., Catani L., Mattioli Belmonte M., Sermasi G., Cascione M.L., Gianni L. et al.:Ticlopidine in the treatment of thrombotic thrombocytopenic purpura: report of two cases. Hematologica 75:274–277, 1990.
Vianelli N., Sermasi G., D'Alessandro R., Zucchelli P., Belardinelli A.R., Catani L. et al.:Prompt plasma-exchange treatment and coma reversibility in two patients with thrombotic thrombocytopenic purpura. Haematologica 76:72–74, 1991.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fiorani, L., Vianelli, N., Gugliotta, L. et al. Brain MRI and SPET in thrombotic thrombocytopenic purpura. Ital J Neuro Sci 16, 149–151 (1995). https://doi.org/10.1007/BF02282981
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02282981