Multi-organ involvement assessed by MRI in patients with thrombotic thrombocytopenic purpura
KeywordsLate Gadolinium Enhancement Regional Wall White Matter Lesion Wall Motion Abnormality Organ Involvement
Thrombotic Thrombocytopenic Purpura (TTP) is an uncommon, acquired, life threatening, autoimmune disorder characterised by multi-organ involvement with microvascular occlusion. Although autopsy studies have shown high incidence of cardiac involvement, clinical evidence of cardiac disease is limited.
We hypothesised that, in TTP: 1) CMR would detect otherwise unrecognized cardiac involvement and 2) this involvement would correlate with other organ involvement.
Thirteen consecutive patients (4 males, 9 females, mean age: 47 ± 13 years), enrolled as part of an observational study, were evaluated with standard cardiac and brain magnetic resonance. The late gadolinium enhancement (LGE) technique was used to assess areas of cardiac focal fibrosis potentially caused by micro-thrombotic damage.
In this pilot study looking at cardiac involvement in TTP by CMR, CMR found LGE patches in one quarter of patients (without wall motion abnormalities). LGE was more likely to be found if there was more severe brain involvement.
This article is published under license to BioMed Central Ltd.