Splenectomy and Antiplatelet Agents in Thrombotic Thrombocytopenic Purpura

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).…”

Rationale and Proposal for Use of Prostacyclin in Thrombotic Thrombocytopenic Purpura Therapy

“…Splenectomy, until recently a standard thera peutic modality, is presently controversial since there is little apparent rationale for its use in TTP [18,69,105]. Nonetheless, splenectomy has been as sociated with induction of TTP remission [9,25,40,66,73]. High doses of corticosteroids (up to 500 mg of prednisone or equivalent per day) are included in many treatment regimens.…”

Potential therapeutic applications of aspirin and other cyclo‐oxygenase inhibitors.

“…This disease is rare and no definitive data on therapy are available. From clinical observations the use of steroid therapy, splenectomy and aspirin administration either singly or in combination may have a beneficial therapeutic effect (Peterson, Amare, Henry & Bone, 1979;Zeluff, Natelson & Jackson, 1978 (Roberts, Carlson & McCracken, 1976). The synthesis of prostaglandin in the hypothalamus can be inhibited by aspirin and aspirin-like drugs which then interfere with the release of luteinizing hormone from the pituitary and inhibit ovulation (Behrman, Orczyk & Greep, 1972;Orczyk & Behrman, 1972;Roberts et al, 1976).…”

“…This disease is rare and no definitive data on therapy are available. From clinical observations the use of steroid therapy, splenectomy and aspirin administration either singly or in combination may have a beneficial therapeutic effect (Peterson, Amare, Henry & Bone, 1979;Zeluff, Natelson & Jackson, 1978).…”