Atypical Presentations of Thrombotic Thrombocytopenic Purpura

Abstract

Thrombotic thrombocytopenic purpura (TTP) usually presents in a fulminant fashion with marked hematologic abnormalities often associated with fever and neurologic and renal abnormalities. Two cases of TTP are reported in which neurologic deficits were initially the dominant findings, followed weeks later by the pronounced hematologic manifestations. Young patients with unexplained neurologic findings, even if there is only minimal anemia or thrombocytopenia, should be monitored for subsequent manifestations of TTP so that treatment may be instituted promptly. Int J Hematol. 2002;76:471-473.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Ridolfi RL, Bell WR. Thrombotic thrombocytopenic purpura: report of 25 cases and review of the literature.Medicine (Baltimore). 1981;60:413–428.

    Article  PubMed  CAS  Google Scholar 

  2. 2.

    Bell WR. Thrombotic thrombocytopenic purpura.JAMA. 1991;265: 91–93.

    Article  PubMed  CAS  Google Scholar 

  3. 3.

    Rose M, Eldor A. High incidences of relapses in thrombotic throm- bocytopenic purpura: a clinical study of 38 patients.Am J Med. 1987;83:437–444.

    Article  PubMed  CAS  Google Scholar 

  4. 4.

    Bell WR, Braine HG, Ness PM, Kickler TS. Improved survival in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: a clinical experience in 108 patients.N Engl J Med. 1991; 325:398–403.

    Article  PubMed  CAS  Google Scholar 

  5. 5.

    Rock GA, Shumak KH, Buskard NA, et al. Comparison of plasma exchange with plasma infusion in the treatment of throm- botic thrombocytopenic purpura. Canadian Apheresis Study Group.N Engl J Med. 1991;325:393–397.

    Article  PubMed  CAS  Google Scholar 

  6. 6.

    Bennett CL, Weinberg PD, Rozenberg-Ben-Drok K, Yarnold PR, Kwaan HC, Green D. Thrombotic thrombocytopenic purpura associated with ticlopidine: a review of 60 cases.Ann Intern Med. 1998; 128:541–544.

    Article  PubMed  CAS  Google Scholar 

  7. 7.

    Kay AC, Solberg LA, Nichols DA, Petitt RM. Prognostic significance of computed tomography of the brain in thrombotic throm- bocytopenic purpura.Mayo Clinic Proc. 1991;66:602–607.

    Article  CAS  Google Scholar 

  8. 8.

    Trent K, Neustater BR, Lottenberg R. Chronic relapsing throm- botic thrombocytopenic purpura and antiphospholipid antibodies: a report of two cases.Am J Hematol. 1997;54:155–159.

    Article  PubMed  CAS  Google Scholar 

  9. 9.

    Joseph R, Tsering C, Grunfeld S, Welch KMA. Platelet secretory products may contribute to neuronal injury.Stroke. 1991;22: 1448–1451.

    Article  PubMed  CAS  Google Scholar 

  10. 10.

    Case records of the Massachusetts General Hospital. Weekly clini- copathological exercises. Case 33-1994. A 41-year-old woman with thrombocytopenia, anemia, and sudden death.N Engl J Med. 1994; 331:661–667.

    Article  Google Scholar 

  11. 11.

    Furlan M, Robles R, Galbusera M, et al. von Willebrand factor- cleaving protease in thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome.N Engl J Med. 1998;339: 1578–1584.

    Article  PubMed  CAS  Google Scholar 

  12. 12.

    Tsai HM, Lian EC. Antibodies to von Willebrand factor-cleaving protease in acute thrombotic thrombocytopenic purpura.N Engl J Med. 1998;339:1589–1594.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding authors

Correspondence to Timothy E. O’Brien or Edward D. Crum.

About this article

Cite this article

O’Brien, T.E., Crum, E.D. Atypical Presentations of Thrombotic Thrombocytopenic Purpura. Int J Hematol 76, 471–473 (2002). https://doi.org/10.1007/BF02982814

Download citation

Key words

  • Thrombotic thrombocytopenic purpura
  • Neurologic deficits