Incomplete Thrombotic Thrombocytopenic Purpura (TTP) with Stroke and Initial Negative Head CT

¹Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, NJ, USA.

²Program Co-Director, Emergency Medicine Residency, Rowan University SOM, Stratford, NJ, USA.

Corresponding Author: James Espinosa, Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, 18 East Laurel Road, Stratford, NJ 08084, USA, Tel: +1 646 241 5695; E-Mail: [email protected]

Received Date: 02 Mar 2016   
Accepted Date: 21 Mar 2016   
Published Date: 04 Apr 2016

Copyright © 2016 Espinosa J

Citation: Mordecai R, Espinosa J, Lucerna A, Scali V, et al. (2016). Incomplete Thrombotic Thrombocytopenic Purpura (TTP) with Stroke and Initial Negative Head CT. Mathews J Emergency Med. 1(1): 005.

ABSTRACT

A 52 year old African American female presented to the Emergency Department for the evaluation of left sided hand and facial weakness. She was noted to have a normal non-contrast head CT; however she did have thrombocytopenia on her complete blood count. Thus, initially the patient had microangiopathic hemolytic anemia (MAHA), thrombocytopenia and a neurological change consistent with thrombotic thrombocytopenia purpura (TTP). Subsequently, the patient developed the TTP pentad of MAHA, renal failure, thrombocytopenia, fever and neurological involvement. Thus the initial presentation was incomplete for the pentad of TTP. This case illustrates that the emergency physician must be on high alert for a patient who presents with neurological symptoms and thrombocytopenia despite not having the complete pentad for TTP.

KEYWORDS

Thrombotic Thrombocytopenia Purpura (TTP); Incomplete Thrombotic Thrombocytopenia Purpura (TTP); Emergency Department; Thrombotic Thrombocytopenia Purpura (TTP); Thrombotic Thrombocytopenia Purpura (TTP); Stroke.