Objective:

To analyze clinical characteristics and causes of misdiagnosis in TTP patients with initial neurological symptoms, explore the efficacy of albumin combined with plasma exchange in TTP treatment during plasma shortages, and provide strategic support for TTP diagnosis and treatment.

Approach:

• Data Collection: Retrospective collection of clinical data including medical history, examination results, diagnosis, and treatment records.
• Treatment Method: Utilization of albumin combined with plasma exchange when plasma inventory was insufficient.
• Monitoring: Dynamic monitoring of laboratory indicators and symptom recovery to evaluate treatment effectiveness and safety.
• Literature Review: Analysis of misdiagnosis risks and current status of alternative treatment through literature review.

Key Findings:

• TTP with initial neurological symptoms can be misdiagnosed as cerebral infarction.
• Thrombocytopenia of unknown origin is a key clue for differential diagnosis.
• TTP should be excluded before administering platelet transfusions.
• Albumin combined with plasma exchange is feasible and effective for treating AB-blood-type TTP when plasma is insufficient.
• Early diagnosis and multidisciplinary collaboration are crucial for improving TTP patient prognosis.

Interpretation:

The study highlights the importance of accurate diagnosis in TTP and presents a viable treatment alternative when plasma is scarce.

Limitations:

• Retrospective nature of the study may introduce bias.
• Limited sample size may affect generalizability of findings.

Conclusion:

The findings support the need for routine screening for TTP in patients with unexplained thrombocytopenia and provide an alternative treatment strategy during plasma shortages.