Thrombotic thrombocytopenic purpura: Report of case

Thrombotic Thrombocytopenic Purpura in Older Patients

“…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 . Two deaths were noted to be directly related to the splenectomy 14,46 . An additional death was noted in the postoperative period but could not be attributed clearly to the surgery 63…”

“…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.…”

“…Gastrointestinal symptoms were present in several patients, including two of our cases. Nausea or vomiting 4–11 and abdominal pain 12–15 or diarrhea 8,10,15 was often noted. One patient was treated with sulfasalazine for presumed inflammatory bowel disease prior to the onset of other symptoms, 17 another developed colitis soon after the disease was diagnosed, 21 and two others had bloody diarrhea at presentation 11,19 .…”

“…Other patients had preceding hypertension 4,32–34 or myocardial infarctions 32,33,35 . Coronary sclerosis, 31 abdominal aortic aneurysm, 14 or a previous cerebrovascular accident 35 was noted in single patients. Two patients had chronic obstructive pulmonary disease 16,36 .…”

“…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 . Two deaths were noted to be directly related to the splenectomy 14,46 .…”