Thrombotic Thrombocytopenic Purpura

Case Studies1 June 1967Thrombotic Thrombocytopenic PurpuraSerial Clotting Studies, Relation to the Generalized Shwartzman Reaction, and Remission After Adrenal Steroid and Dextran TherapyROBERT G. LERNER, M.D., SAMUEL I. RAPAPORT, M.D., F.A.C.P., JAMES MELTZER, M.D.ROBERT G. LERNER, M.D.Search for more papers by this author, SAMUEL I. RAPAPORT, M.D., F.A.C.P.Search for more papers by this author, JAMES MELTZER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-6-1180 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThrombotic thrombocytopenic purpura (TTP) was first described by Moschcowitz (1) in 1925. It is an acute, fluctuating illness whose major clinical manifestations are thrombocytopenia, hemolytic anemia with characteristically fragmented red blood cells, changing neurologic findings, fever, jaundice with both direct and indirect bilirubinemia, and renal abnormalities. When a patient exhibits all six of these findings, one may make the diagnosis clinically—provided, however, that other disorders that may mimic TTP (for example, systemic lupus erythematosus or metastatic malignancy with disseminated intravascular coagulation) have been searched for carefully and eliminated. The pathologic diagnosis requires more than the demonstration of hyaline thrombi in...References1. MOSCHCOWITZ E: Acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries: an undescribed disease. Arch. Intern. Med. (Chicago) 36: 89, 1925. CrossrefGoogle Scholar2. MCKAY DG: Disseminated Intravascular Coagulation: An Intermediary Mechanism of Disease. 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RAPAPORT, M.D., F.A.C.P.; JAMES MELTZER, M.D.Affiliations: Los Angeles, CaliforniaFrom the Department of Medicine, the University of Southern California School of Medicine and the Los Angeles County General Hospital, Los Angeles, Calif.This study was supported by grants TI AM 05192-08 and HE 06128-06, the U. S. Public Health Service, Washington, D. C.At the time of this study Dr. Lerner was a trainee in the Graduate Training Program in Hematology, University of Southern California School of Medicine, Los Angeles, Calif.Requests for reprints should be addressed to Robert G. Lerner, M.D., University of Southern California School of Medicine, 2025 Zonal Ave., Los Angeles, Calif. 90033. 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THE GENERALIZED SHWARTZMAN REACTIONCase 29-1969Clinical pathologic conferenceDefibrination syndrome in a patient with chronic thrombocytopenic purpuraRecognition and treatment of intravascular coagulationTreatment of Patients with Microangiopathic Haemolytic Anaemia with HeparinMicroangiopathic Hemolytic Anemia Caused by Purpura FulminansJOHN H. HOLLINGSWORTH, M.D., DANIEL N. MOHLER, M.D., F.A.C.P. 1 June 1967Volume 66, Issue 6Page: 1180-1190KeywordsFeversGraduate medical educationHematology and oncologyHemolytic anemiaHospital medicineLupus erythematosusMedical servicesPartial thromboplastin timeRed blood cellsThrombotic thrombocytopenic purpura ePublished: 1 December 2008 Issue Published: 1 June 1967 PDF downloadLoading ...