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JAMA. 1962;181(12):1070-1071. doi:10.1001/jama.1962.03050380048014.
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Sternal marrow biopsy has proven effective in establishing the diagnosis of thrombotic thrombocytopenic purpura. The etiology of this condition is unknown, but it is associated with endothelial proliferation which especially involves the vessels of the adrenal cortex, myocardium, brain, pancreas, and kidneys. Six cases in which this diagnosis was made in the period 1950-1959 at the Mayo Clinic are reported in the July issue of the Archives of Internal Medicine.1

This uncommon disease entity characterized by thrombocytopenia, hemolytic anemia, transitory neurological symptoms, fever, and mild to moderate nephropathy has been difficult to diagnose ante mortem. Since the disease was first delineated by Moschcowitz in 1925, various procedures such as lymph node and skin biopsy have been suggested and utilized in the past. Bone marrow aspirates were considered unreliable by previous clinicians.

Ruffolo, Pease, and Cooper have demonstrated that the vascular lesion in random samples of bone marrow has been


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