Summary. The presence of anti-CD36 antibodies in plasma of patients with thrombotic thrombocytopenic purpura (TTP), idiopathic thrombocytopenic purpura (ITP), and heparininduced thrombocytopenia without/with thrombosis (HIT/ HITT) has been examined by immunoblots, and a monoclonal antibody capture assay, the platelet-associated IgG characterization assay (PAICA). Results with PAICA showed that 73% (8/11) of patients with TTP were positive, and 71% (10/14) by immunoblots. With ITP, 20% (6/30) were positive by PAICA and 19% (3/16) by immunoblots; HIT, 30% (3/10) were positive by PAICA and 60% (6/10) by immunoblot; HITT, 50% (2/4) by PAICA and 100% (4/4) by immunoblot. Purification of CD36 by fast protein liquid chromatography (FPLC) from Triton X-100 extracts of normal platelet membranes resulted in the isolation of two different forms: the classic 88 kD form, and a second, lighter 85 kD form. Our data indicated that the patients' plasma autoantibodies reacted strongly with the 85 kD form. Conventional monoclonal and polyclonal antisera produced to the 88 kD form reacted strongly with the 88 kD form but weakly with the 85 kD form. These results confirm the possible importance of anti-CD36 antibodies in the pathophysiology of TTP and other thrombocytopenias and demonstrate the presence of a previously unrecognized target antigen for these antibodies.Keywords: thrombosis, thrombocytopenia, platelets, glycoform, immunoassays.The human CD36 is a single-chain integral membrane polypeptide (also known as GPIV; IIIb) expressed by platelets as well as many other cells, cell lines and tissues (Okumura & Jamieson, 1976;Asch et al, 1987;Tandon et al, 1989b;Greenwalt et al, 1990Greenwalt et al, , 1992. Numerous functions have been described for CD36, including a role as a cell surface receptor interactive with a large number of ligands, in cytoadhesion reactions, and implication in intracellular signal transduction (Jaffe et al, 1982;Leung, 1984;Silverstein et al, 1984Silverstein et al, , 1989Majack et al, 1988;Kieffer et al, 1989; Tandon et al, 1989a,b;Good et al, 1990;Murphy-Ullrich et al, 1992;Savill et al, 1992;Greenwalt et al, 1992;Endemann et al, 1993;Abumrad et al, 1993;Kehrel et al, 1998).The molecular mass of CD36 on different cells is variable; for example, M r values of 88 000, 85 000 and 78 000 have been reported for human platelets, human mammary epithelial cells, and human erythroblasts, respectively (Tandon et al, 1989b;Greenwalt et al, 1990;Kieffer et al, 1989).A cDNA clone encoding CD36 was isolated from a human placenta cDNA library and expressed in COS cells by Oquendo et al (1989), resulting in a polypeptide with 471 residues and a predicted M r of approximately 53 kD. The identification of 10 potential N-linked glycosylation sites accounted for the difference in M r between the polypeptide and the 83 kD species found by immunoprecipitation with a pool of mouse monoclonal anti-CD36 antibodies. Tandon et al (1989b) purified CD36 from solubilized Triton X-114 extracts of human platelet membranes, and report...