Abstract
Thrombotic thrombocytopenic purpura (TTP) is a disease process characterized by microangiopathic anemia, fever, neurologic manifestations, renal abnormalities, and thrombocytopenia. These clinical findings are caused by vascular occlusions of the microcirculation. At present the utilization of splenectomy, in the treatment of this illness, remains a highly controversial subject. However, review of the literature reveals that 70% of the long term survivors of TTP had undergone splenectomy. This report presents five patients with TTP, four of whom had been splenectomized. Long term survival (greater than one year) was achieved in three individuals. It is recommended that splenectomy be considered as part of the initial management of all patients with TTP, in addition to high dose corticosteroids and antiplatelet drugs.
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Selected References
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- Amorosi E. L., Karpatkin S. Antiplatelet treatment of thrombotic thrombocytopenic purpura. Ann Intern Med. 1977 Jan;86(1):102–106. doi: 10.7326/0003-4819-86-1-102. [DOI] [PubMed] [Google Scholar]
- Bernard R. P., Bauman A. W., Schwartz S. I. Splenectomy for thrombotic thrombocytopenic purpura. Ann Surg. 1969 Apr;169(4):616–624. doi: 10.1097/00000658-196904000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Byrnes J. J., Khurana M. Treatment of thrombotic thrombocytopenic purpura with plasma. N Engl J Med. 1977 Dec 22;297(25):1386–1389. doi: 10.1056/NEJM197712222972507. [DOI] [PubMed] [Google Scholar]
- Cuttner J. Splenectomy, steroids, and dextran 70 in thrombotic thrombocytopenic purpura. JAMA. 1974 Jan 28;227(4):397–402. [PubMed] [Google Scholar]
- Goldenfarb P. B., Finch S. C. Thrombotic thrombocytopenic purpura. A ten-year survey. JAMA. 1973 Nov 5;226(6):644–647. [PubMed] [Google Scholar]
- Kadri A., Noinuddin M., de Leeuw N. K. Phagocytosis of blood cells by splenic macrophages in thrombotic thrombocytopenic purpura. Ann Intern Med. 1975 Jun;82(6):799–802. doi: 10.7326/0003-4819-82-6-799. [DOI] [PubMed] [Google Scholar]
- MEACHAM G. C., ORBISON J. L., HEINLE R. W., STEELE H. J., SCHAEFER J. A. Thrombotic thrombocytopenic purpura, a disseminated disease of arterioles. Blood. 1951 Aug;6(8):706–719. [PubMed] [Google Scholar]
- RODRIGUEZ H. F., BABB D. F., PEREZ SANTIAGO E., COSTAS-DURIEUX J. Thrombotic thrombocytopenic purpura; remission after splenectomy. N Engl J Med. 1957 Nov 14;257(20):983–985. doi: 10.1056/NEJM195711142572007. [DOI] [PubMed] [Google Scholar]
- Reynolds P. M., Jackson J. M., Brine J. A., Vivian A. B. Thrombotic thrombocytopenic purpura--remission following splenectomy. Report of a case and review of the literature. Am J Med. 1976 Sep;61(3):439–447. doi: 10.1016/0002-9343(76)90385-5. [DOI] [PubMed] [Google Scholar]
- Schwartz J., Rosenberg A., Cooperberg A. A. Thrombotic thrombocytopenic purpura: successful treatment of two cases. Can Med Assoc J. 1972 Jun 10;106(11):1200–passim. [PMC free article] [PubMed] [Google Scholar]