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- 2025-10-14 发布于北京
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TTP2019:STATEOFTHEART
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TTP:long-termoutcomesfollowingrecovery
JamesN.George
Hematology-OncologySection,DepartmentofMedicine,CollegeofMedicine,UniversityofOklahomaHealth
SciencesCenter,OklahomaCity,OK
Althoughriskforrelapsemaybethegreatestconcernfollowingrecoveryfromacquired,autoimmunethrombotic
thrombocytopenicpurpura(TTP),therearemultipleothermajorhealthissuesthatmustberecognizedandappropriately
addressed.DepressionmaybethemostcommondisorderfollowingrecoveryfromTTPandmaybethemostimportant
issueforthepatient’squalityoflife.Severeormoderatedepressionhasoccurredin44%ofOklahomaRegistrypatients.
Recognitionofdepressionbyroutinescreeningevaluationsisessential;treatmentofdepressioniseffective.Minor
cognitiveimpairmentisalsocommon.TherecognitionthatcognitiveimpairmentisrelatedtotheprecedingTTPcan
providesubstantialemotionalsupportforboththepatientandherfamily.BecauseTTPcommonlyoccursinyoungblack
women,thefrequencyofsystemiclupuserythematosus,aswellasotherautoimmunedisorders,isincreased.Because
thereisarecognizedassociationofTTPwithpregnancy,thereisalwaysconcernforsubsequentpregnancies.Inthe
OklahomaRegistryexperience,relapsehasoccurredinonly2of22pregnancies(2of13women).Thefrequencyofnew-
onsethypertensionisincreased.ThemoststrikingevidencefortheimpactofmorbiditiesfollowingrecoveryfromTTPis
decreasedsurvival.Amongthe77patientswhosurvivedtheirinitialepisodeofTT
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