Plasmapheresis in the Treatment of Thrombotic Thrombocytopenic Purpura: A Report of Five Cases

Close relationship between systemic lupus erythematosus and thrombotic thrombocytopenic purpura in childhood

“…We also eliminated articles if patients were known to have SLE before the diagnosis of TTP, or if the publication described laboratory experiments investigating the pathogenesis of TTP. These exclusions left us with 91 citations (2)(3)(4)(5)9, for review, from which we identified 44 cases of pediatric-onset TTP (9,(11)(12)(13)16,17,20,27,28,(32)(33)(34)38,40,41,43,45,46,(53)(54)(55)57,58,63,65,70,72,73,80,82,83,91,94). We screened the bibliography of all 91 citations for additional case reports or relevant articles, but could not identify any.…”

“…Review of these articles showed that 14 of the 44 cases lacked detailed information on the disease course or sufficient laboratory data to determine whether SLE was present or absent. Therefore, 30 patients described in the literature (9,(11)(12)(13)20,28,33,38,40,41,43,45,46,53,54,58,63,65,70,73,80,82,91,94) and 5 HSC patients were included in the total cohort. This cohort was divided into 2 groups based on the presence or absence of the American College of Rheumatology (ACR) classification criteria for SLE (7).…”

Thrombotic Thrombocytopenic Purpura in Older Patients

“…Four of these cases did not receive plasma 39 . The other 15 patients died 4,12,14,22,26,32,33,36,39,40,45,49–63 . Four of them also had plasma exchanges, 14,22,48,63 one had whole blood exchange transfusions, 45 five received whole blood, 12,26,36,40,46 and five received no plasma 4,32,33,39,47,48 .…”

“…Patient Background One hundred and one cases of thrombotic thrombocytopenic purpura (TTP) in patients 50 years of age or older, including the three patients in this report (Table 1) are reported in the English medical literature 1,2,4–64 . The age distribution of these patients is shown in Figure 1.…”

“…Seven patients were treated for urinary tract infections in the weeks prior to the onset of other clinical manifestations of thrombotic thrombocytopenic purpura 12,19,21,36,43,49 . One patient presented with chronic glomerular disease simulating glomerulonephritis before recognition of other feature of TTP 22 …”