Thrombotic Thrombocytopenic Purpura

  • Donald E. Thornton
  • Earl N. Metz
Part of the Contemporary Internal Medicine book series (COIM, volume 3)


A 32-year-old carpenter was in vigorous good health until about two months before his admission to the hospital when he began to be aware of increasing fatigue and some loss of appetite. A few weeks later, he developed shortness of breath with exertion and some cough. He did not seek medical attention, however, until the onset of numbness and tingling in his right arm and leg. He was hospitalized and additional history included the absence of fever, chills, significant weight loss, or muscle weakness. His physician did note the presence of scleral icterus and multiple ecchymoses of the skin. The initial laboratory evaluation included a hemoglobin concentration of 6.3 g/dl and a platelet count of 28,000μl. Numerous fragmented red cells (schistocytes) were noted in the peripheral blood film. His reticulocyte count was elevated at 11%. The lactic dehydrogenase concentration in the serum was markedly elevated at 3,275 units and the fibrinogen concentration was slightly reduced at 125 mg/dl. The prothrombin and partial thromboplastin times were normal. A bone marrow aspiration was performed and demonstrated increased megakaryocytes and erythroid hyperplasia. Therapy was begun with prednisone, aspirin, dipyridamole, and red cell transfusions but three days later his platelet count had not improved and he developed expressive aphasia. Arrangements were made for transfer to The Ohio State University Hospital.


Systemic Lupus Erythematosus Hemolytic Anemia Plasma Exchange Thrombotic Thrombocytopenic Purpura Expressive Aphasia 
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Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Donald E. Thornton
  • Earl N. Metz

There are no affiliations available

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