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ARTICLE |

Thrombotic Thrombocytopenic Purpura FREE

William Bell, MD
[+] Author Affiliations

Reprint requests to Hematology Division, The Johns Hopkins Hospital, 600 N Wolfe St, Blalock 1036, Baltimore, MD 21205 (Dr Bell).


JAMA. 1991;265(1):91-93. doi:10.1001/jama.1991.03460010091038
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CASE PRESENTATION  —Charles T. Bingham III, MDA 27-YEAR-OLD man was transferred to The Johns Hopkins Hospital for evaluation of delirium. Five days prior to admission he had presented to another hospital with hematemesis and syncope. Esophagogastroduodenoscopy revealed the presence of a 0.5-cm gastric ulcer. The hematocrit value and the platelet count were low. The patient was treated with packed red blood cells (RBCs) and platelets. During the next few days, he developed agitation, confusion, and hallucinosis and was transferred to The Johns Hopkins Hospital.His past medical history was remarkable for alcoholic hepatitis. The patient drank a minimum of one pint of rum plus large volumes of wine daily. He denied taking any medications.On physical examination, the patient's temperature was 38.9°C; blood pressure, 128/86 mm Hg; pulse rate, 96 beats per minute; and respirations, 24/min. The sclerae were icteric. The liver and spleen were not enlarged, and the

REFERENCES

Moschcowitz E.  Hyaline thrombosis of the terminal arterioles and capillaries: a hitherto undescribed disease . Proc N Y Pathol Soc. 1924;;24:21-24.
Moschcowitz E.  An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries . Arch Intern Med. 1925;;31:89-93.
Singer K.  Thrombotic thrombocytopenic purpura . Adv Intern Med. 1954;;6:195-234.
Gasser VC, Gauter E, Steck A, Siebenmann RE, Oechelin R.  Hämolytisch-uramische Syndrome: bilaterale Nierenvindenmekrosen bei akuten erworbenen hämolytischen Anämien . Schweiz Med Wochenschr. 1955;;85:905-909.
Byrnes JJ, Mooke JL.  Thrombotic thrombocytopenic purpura and the haemolytic-uraemic syndrome: evolving concepts of pathogenesis and therapy . Clin Haematol. 1986;;15:413-442.
Remuzzi G.  HUS and TTP: variable expression of a single entity . Kidney Int. 1987;;32:292-308.
Amorosi EL, Ultman JE.  Thrombotic thrombocytopenic purpura: report of 16 cases and review of the literature . Medicine . 1966;;45:139-159.
Ridolfi RL, Bell WR.  Thrombotic thrombocytopenic purpura: report of 25 cases and review of the literature . Medicine . 1981;;60:413-428.
Bartholomew JR, Bell WR.  Thrombotic thrombocytopenic purpura . J Intensive Care Med. 1986;;1:341-355.
Feldman JD, Mardinez MR, Unanue ER, Cutting H.  The vascular pathology of thrombotic thrombocytopenic purpura . Lab Invest. 1966;; 15:927-946.
Umlos J, Kaiser J.  Thrombohemolytic thrombocytopenic purpura (TTP) . Am J Med. 1970;; 49:723-728.
Ridolfi RL, Hutchins GM, Bell WR.  The heart and cardiac conduction system in thrombotic thrombocytopenic purpura . Ann Intern Med. 1979;;91:357-363.
Lian ECY.  Pathogenesis of thrombotic thrombocytopenic purpura . Semin Hematol. 1987;;24:82-100.
Bukowski RM.  Thrombotic thrombocytopenic purpura: a review . Prog Hemost Thromb. 1982;; 6:287-337.

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Moschcowitz E.  Hyaline thrombosis of the terminal arterioles and capillaries: a hitherto undescribed disease . Proc N Y Pathol Soc. 1924;;24:21-24.
Moschcowitz E.  An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries . Arch Intern Med. 1925;;31:89-93.
Singer K.  Thrombotic thrombocytopenic purpura . Adv Intern Med. 1954;;6:195-234.
Gasser VC, Gauter E, Steck A, Siebenmann RE, Oechelin R.  Hämolytisch-uramische Syndrome: bilaterale Nierenvindenmekrosen bei akuten erworbenen hämolytischen Anämien . Schweiz Med Wochenschr. 1955;;85:905-909.
Byrnes JJ, Mooke JL.  Thrombotic thrombocytopenic purpura and the haemolytic-uraemic syndrome: evolving concepts of pathogenesis and therapy . Clin Haematol. 1986;;15:413-442.
Remuzzi G.  HUS and TTP: variable expression of a single entity . Kidney Int. 1987;;32:292-308.
Amorosi EL, Ultman JE.  Thrombotic thrombocytopenic purpura: report of 16 cases and review of the literature . Medicine . 1966;;45:139-159.
Ridolfi RL, Bell WR.  Thrombotic thrombocytopenic purpura: report of 25 cases and review of the literature . Medicine . 1981;;60:413-428.
Bartholomew JR, Bell WR.  Thrombotic thrombocytopenic purpura . J Intensive Care Med. 1986;;1:341-355.
Feldman JD, Mardinez MR, Unanue ER, Cutting H.  The vascular pathology of thrombotic thrombocytopenic purpura . Lab Invest. 1966;; 15:927-946.
Umlos J, Kaiser J.  Thrombohemolytic thrombocytopenic purpura (TTP) . Am J Med. 1970;; 49:723-728.
Ridolfi RL, Hutchins GM, Bell WR.  The heart and cardiac conduction system in thrombotic thrombocytopenic purpura . Ann Intern Med. 1979;;91:357-363.
Lian ECY.  Pathogenesis of thrombotic thrombocytopenic purpura . Semin Hematol. 1987;;24:82-100.
Bukowski RM.  Thrombotic thrombocytopenic purpura: a review . Prog Hemost Thromb. 1982;; 6:287-337.
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