Thrombotic Purpura Research Articles

Apheresis activity in Venezuela

Interest for apheresis activity has been growing in Venezuela. In 1976 there were only a few devices; in 2003, 80 apheresis machines performed 27,675 donor apheresis procedures and 547 therapeutic procedures countrywide. We report the activity at the Metropolitan Blood Bank (the largest one of the country) in the period 1999-2003: 597 therapeutic procedures were performed in 171 patients, during 212 crisis episodes. The average age was 38 +/- 16 years, 65% male and 35% female. Most of the therapeutic procedures were therapeutic plasma exchange for hematology diseases (mainly thrombotic thrombocitopenic purpura and hemophilia inhibitors), including 184 therapeutic procedures with the Autopheresis-C (Baxter Healthcare Corp., Deerfield, IL). Most common adverse effects (3.9%) were hypotension and allergic reactions to the plasma.

Radiographically Occult, Diffuse Intrasinusoidal Hepatic Metastases From Primary Breast Carcinomas: A Clinicopathologic Study of 3 Autopsy Cases

Abstract Context.—Liver metastases usually present as radiographically detectable mass lesions that do not significantly compromise liver function. Rarely, metastatic carcinoma can diffusely infiltrate hepatic sinusoids, a pattern of metastasis that may be missed on imaging studies, and can result in liver failure. Objective.—To describe the clinicopathologic features of 3 cases of diffuse intrasinusoidal hepatic metastases from primary breast carcinomas identified at autopsy. Design.—Clinical histories and radiographic, macroscopic, and microscopic appearances of the livers were compared. Sampled liver tissue was stained with antibodies to E-cadherin, smooth muscle actin, and CD44. Results.—Two of 3 cases had a history of infiltrating ductal carcinoma of the breast and presented with new-onset liver failure, but no hepatic metastases were identified on radiologic imaging. An additional case had no history of carcinoma, presented with a severe thrombocytopenic thrombotic purpura–like syndrome, and metasta...

Radiographically Occult, Diffuse Intrasinusoidal Hepatic Metastases From Primary Breast Carcinomas: A Clinicopathologic Study of 3 Autopsy Cases

Liver metastases usually present as radiographically detectable mass lesions that do not significantly compromise liver function. Rarely, metastatic carcinoma can diffusely infiltrate hepatic sinusoids, a pattern of metastasis that may be missed on imaging studies, and can result in liver failure. To describe the clinicopathologic features of 3 cases of diffuse intrasinusoidal hepatic metastases from primary breast carcinomas identified at autopsy. Clinical histories and radiographic, macroscopic, and microscopic appearances of the livers were compared. Sampled liver tissue was stained with antibodies to E-cadherin, smooth muscle actin, and CD44. Two of 3 cases had a history of infiltrating ductal carcinoma of the breast and presented with new-onset liver failure, but no hepatic metastases were identified on radiologic imaging. An additional case had no history of carcinoma, presented with a severe thrombocytopenic thrombotic purpura-like syndrome, and metastatic carcinoma of the breast was diagnosed only at autopsy. The livers in all 3 cases at autopsy were homogeneous, firm, and tan-yellow, and contained no large metastatic lesions. Microscopically, poorly differentiated carcinoma diffusely infiltrated hepatic sinusoids. Antibodies to smooth muscle actin stained activated hepatic stellate cells lining involved sinusoids. Cell surface adhesion molecules, E-cadherin or CD44, were not detected in any hepatic metastases. Diffuse intrasinusoidal hepatic metastases of breast carcinoma can occupy a large percentage of the hepatic volume, yet remain occult both radiographically and macroscopically. This type of metastatic spread can present as cryptogenic liver failure. The 3 cases we studied were associated with an absence of E-cadherin and CD44 expression.

“Bleeding heart”: Cardiac complications in thrombotic thromobocytopenic purpura

“Bleeding heart”: Cardiac complications in thrombotic thromobocytopenic purpura

What Are Appropriate Initial and Salvage Therapies for Patients with Thrombotic Thrombocyopenic Purpura (TTP)?

Although much has been learned about the pathophysiologic process of thrombotic thrombocytopenic purpura (TTP), both diagnostically and therapeutically, since its initial description by Moschowitz in 1924, its etiology and treatments remain, in many instances, problematic. Thrombotic thrombocytopenic purpura remains a rare entity whose etiology is usually unknown, but several drugs and infections have now been implicated in its development. Although treatment by plasma exchange has gained worldwide acceptance, the optimal exchange media is not known, nor the volume and duration of exchange therapy, not appropriate salvage therapies. Without the benefit of randomized controlled trials, its treatment, to a large extent, remains not evidence-based but "eminence-based", making the same mistakes with increasing confidence over decades.

Thrombocytopenic thrombotic purpura: severe clinic with no CT, minor MRI, but a SPECT correlate

A 28-year-old woman with primarily therapy refractory TTP was followed neuroradiologically over 6 months. Despite pronounced neurological and neuropsychiatric symptoms including hemiparesis and aphasia she had unremarkable CT scans on two occasions. Three MRI exams showed no correlate for her neurological symptoms except a small petechial cortical hemorrhage in the right parietooccipital gyrus which may account for her TTP-related anxiety disorder. A cerebral HMPAO-SPECT showed long-standing right-sided hypoperfusion compatible with residual vasculature changes. The possible causes for the clinico-neuroradiological discrepancies are discussed in view of the literature.

Frontiers in interventional cardiology.

n more than 20 years since the first percutaneous coronary revascularization procedures, the field of interventional cardiology has proliferated beyond all expectations. Now more than 1 million procedures are performed worldwide each year. Stenting has revolutionized the field, which previously relied on balloon dilatation in the majority of patients. With 50% of patients now undergoing stent implantation, the groundwork is laid for further important advances. In this article, we discuss the 4 most important new advances in the field of interventional cardiology: platelet inhibition, prevention of restenosis, stent evolution, and angiogenesis.

Localized thrombotic purpura: A rare complication of chickenpox

We report three cases of localized thrombotic purpura that appeared during the convalescence phase of common chickenpox. This rare complication is characterized by localized symmetric ecchymotic purpura often affecting the lower limbs and often accompanied with signs of disseminated intravascular coagulation. In two cases we found transient protein S deficiency.(J Pediatr 1997;130:655-7)

Haemolytic Uraemic Syndrome and Thrombocytopenic Thrombotic Purpura

Haemolytic uraemic syndrome thrombocytopenic thrombotic purpura (HUS/TTP) remains an incompletely understood complex disease process that involves many organs. It was first described, as thrombocytopenic purpura, by Moschcowitz in 1924 (1). Since that time the prognosis of this disease has improved considerably, the short term mortality declining from 90% to 10%. Challenging questions remain, however, about clinical classification, pathophysiology, and therapy of the initial episode and later relapse. The present art and science of classification, pathophysiology and therapy, plus recommendations for future approaches are presented in this paper.

A case of thrombocytopoenic thrombotic purpura preceding onset of systemic lupus erythematosus

Journal of Clinical ApheresisVolume 11, Issue 1 p. 51-52 Letter to the Editor A case of thrombocytopoenic thrombotic purpura preceding onset of systemic lupus erythematosus G. Di Pietro, G. Di Pietro Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this authorA. Menicucci, A. Menicucci Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this authorS. Venturini, S. Venturini Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this authorG. Avanzi, G. Avanzi Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this author G. Di Pietro, G. Di Pietro Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this authorA. Menicucci, A. Menicucci Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this authorS. Venturini, S. Venturini Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this authorG. Avanzi, G. Avanzi Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, ItalySearch for more papers by this author First published: 1996 https://doi.org/10.1002/(SICI)1098-1101(1996)11:1<51::AID-JCA12>3.0.CO;2-%23Citations: 1 Blood Transfusion Center, Immunogenetic Department Careggi Hospital-University, Florence, Italy AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume11, Issue11996Pages 51-52 RelatedInformation

A case of thrombocytopoenic thrombotic purpura preceding onset of systemic lupus erythematosus

A case of thrombocytopoenic thrombotic purpura preceding onset of systemic lupus erythematosus

Purpura thrombotique thrombocytopénique après prise d'anti-agrégants plaquettaires

Thrombotic thrombocytopeniec purpura (TTP) is a rare but severe adverse effect from some drugs. The authors report two cases of TTP associated with antiplatelet therapy, ticlopidine and aspirin.

Thrombotic thrombopenic purpura therapy - too good to be true?

Thrombotic thrombopenic purpura therapy - too good to be true?

Association purpura thrombocytopénique thrombotique et cancer : un nouveau cas

The association between thrombocytopenic thrombotic purpura (TTP) and infectious or multisystem disease, pregnancy, transplantation, drugs and toxins is well known. The onset of TTP in the course of neoplasm is rarely described : only 7 cases have been reported (5 cases of gastric adenocarcinoma, 1 case of breast carcinoma and 1 case of carcinoma with unknown primary site). The authors report the first case of TTP associated with prostatic tumor.

Thrombotic Thrombocytopoenic purpura during oral Contraceptive Treatment

A report connecting hemolytic uraemic syndrome with intake of drugs containing estrogens is presented in a letter. A patient during oral contraceptive (OC) treatment developed thrombotic thrombocytopenic purpura (TTP). The patient was 22 years old and had been taking OCs (.05 mg ethinyl estradiol .5 mg norgestrel) continously for 13 cycles; she developed thrombocytopenia hemolytic anemia and neurological abnormalities a few days after a hyperpyrexia episode. Brain involvement was severe; treatment with heparin cortiscosteroids antiplatelet drugs plasma exchange and occasional thrombolytic therapy with urokinase was successful within 2 months. Conceivably drugs containing estogens predispose women to this microangiopathic condiction especially when combined with other vascular risk factors such as viral or bacterial infections (as suggested by the high-fever episode in this case which preceded clinical expression of TTP).

Generalized cytomegalic inclusion-body disease associated with pneumocystis pneumonia in adults. A report of three cases. with Wegener's granulomatosis. thrombotic purpura, and Hodgkin's disease as predisposing conditions.

Three cases of generalized cytomegalic inclusion-body disease (salivary virus disease) in adults are reported, bringing the number of published cases up to 34. The infection is very rare in adults although well known in infants. As is often found in infants with this disease, pneumonia due to Pneumocystis carinii was also present in each case. The first patient had Wegener's granulomatosis, which presented with acute otitis media: a review of histological material obtained at mastoidectomy eight weeks before death showed that inclusion-body cytomegaly was already present then. Various antibiotics and prednisolone were given, and the lesions in the respiratory organs and the arteritis healed to a considerable extent. Renal failure, however, was progressive and led to death. The second patient had thrombotic purpura and died after a few weeks' illness, during which oxytetracycline and hydrocortisone were given. Congenital absence of the spleen was found at laparotomy, which was performed with the object of doing a splenectomy. Focal cryptococcal pneumonia was present post mortem: six years before death a solitary cryptococcal granuloma of one lung had been treated by lobectomy. The third patient had had Hodgkin's disease for 18 years. During the first 12 years the disease had the characteristics of the so-called indolent form ("Hodgkin's paragranuloma") and it then passed into the typical form. Deep x-ray therapy and cytotoxic drugs were used during the course of the disease at various times, and streptomycin and tuberculostatic drugs were given because of intercurrent tuberculous meningitis which developed three months before death. In all three cases it seems likely that the underlying disease, or the drugs used in its treatment, predisposed to cytomegalic inclusion-body disease and concomitant pneumocystis pneumonia by lowering the patients' resistance. Just as some unusual types of fungal and bacterial infections have become less rare since the introduction of certain drugs, including antibiotics and steroids, it is possible that cytomegalic inclusion-body disease and pneumocystis infection may also be met with oftener in adults, perhaps particularly as a complication of the use of these drugs in the treatment of diseases which are specially liable to interfere with the body's defences.

On the differential diagnosis of thrombotic microangiopathy in endometrial curettings.

Ina paperpublished three yearsagoonthe histological diagnosis of thrombotic purpura during life Ireported three cases inwhichthe characteristic thrombotic microangiopathy was present inbiopsy material (Symmers, 1956). In oneofthecases thevascular lesions werefoundin thebasalstratum oftheendometrium andin endocervical fragments inaspecimen obtained by curettage: theoperation hadbeenperformed because ofsevere menorrhagia attheonset ofthe illness, whenthere werenoclinical grounds for suggesting thediagnosis ofthrombotic purpura. The patient's satisfactory condition afterthe curettage andtheabsence ofdiagnostic haematojW.I P / ~ ~~ ~ ~ ; A ' < <*< <* Xs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. So.

DIALYSIS IN PEDIATRICS, INCLUDING USE OF THE ARTIFICIAL KIDNEY

AN EXTENSIVE experience has been reported on use of the artificial kidney in adults. In contrast, two reports concerning 10 patients comprise the bulk of published experience in the pediatric age period. None of the children in these reports was less than 5 years old. This discrepancy suggests either that clinical situations requiring dialysis are less frequent in children or a more suitable alternate means of dialysis is available for children, or both. The artificial kidney is used in four clinical circumstances in adults: 1) acute tubular necrosis from prolonged shock, nephrotoxic poisons, drug sensitization and hemolysis, 2) acute glomerular failure associated with acute glomerulonephritis, cortical necrosis, thrombotic thrombopenic purpura and other acute vascular disorders; 3) acute renal failure in patients with chronic renal disease in whom decompensation results from a reversible state, such as an infection; 4) acute poisoning with a dialyzable agent.