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. 1960 Mar;13(2):124–132. doi: 10.1136/jcp.13.2.124

THROMBOTIC THROMBOCYTOPENIC PURPURA

REPORT OF A CASE PRESENTING AS A CHRONIC NEUROLOGICAL DISORDER AND CHARACTERIZED BY UNUSUAL HISTOLOGICAL FINDINGS

B Bornstein 1,2, J H Boss 1,2, J Casper 1,2, M Behar 1,2
PMCID: PMC480020  PMID: 13802905

Abstract

A case of thrombotic thrombocytopenic purpura in a 50-year-old woman is described. Almost the whole course of the disease, lasting 18 months, was characterized by a bizarre neurological disorder, and the haematological manifestations first appeared at a late stage.

In many organs a vast number of arterioles and capillaries contained plugs of a fibrinoid material, and fibrinoid was subendothelially accumulated in a few of these vessels; but, in addition, mediumsized arteries of the myocardium were also obstructed by this same material. There were also verrucal endocardiosis of the mitral valve and slight thickening of the glomerular basement membranes. The striking diffusion of a pathological substance through damaged cerebral vessel walls into the nervous tissue seems to be a significant contribution to the understanding of the pathogenesis of the vascular pathology of thrombotic thrombocytopenic purpura.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen A. C., Sirota J. H. The Morphogenesis and Significance of Degenerative Verrucal Endocardiosis (Terminal Endocarditis, Endocarditis Simplex, Nonbacterial Thrombotic Endocarditis). Am J Pathol. 1944 Nov;20(6):1025–1055. [PMC free article] [PubMed] [Google Scholar]
  2. BEIGELMAN P. M. Variants of the platelet thrombosis syndrome and their relationship to disseminated lupus. AMA Arch Pathol. 1951 Feb;51(2):213–223. [PubMed] [Google Scholar]
  3. BURKE H. A., Jr, HARTMANN R. C. Thrombotic thrombocytopenic purpura; two patients with remission associated with the use of large amounts of steroids. AMA Arch Intern Med. 1959 Jan;103(1):105–112. doi: 10.1001/archinte.1959.00270010111014. [DOI] [PubMed] [Google Scholar]
  4. COOPER T., STICKNEY J. M., PEASE G. L., BENNETT W. A. Thrombotic thrombocytopenic purpura; confirmation of clinical diagnosis by bone marrow aspiration. Am J Med. 1952 Sep;13(3):374–383. doi: 10.1016/0002-9343(52)90290-8. [DOI] [PubMed] [Google Scholar]
  5. CRAIG J. M., GITLIN D., JANEWAY J. A. Studies on the nature of fibrinoid in the collagen diseases. Am J Pathol. 1957 Jan-Feb;33(1):55–77. [PMC free article] [PubMed] [Google Scholar]
  6. CRAIG J. M., GITLIN D. The nature of the hyaline thrombi in thrombotic thrombocytopenic purpura. Am J Pathol. 1957 Mar-Apr;33(2):251–265. [PMC free article] [PubMed] [Google Scholar]
  7. FISHER E. R., CREED D. L. Thrombotic thrombocytopenic purpura; report of a case with discussion of its tinctorial features. Am J Clin Pathol. 1955 Jun;25(6):620–628. doi: 10.1093/ajcp/25.6.620. [DOI] [PubMed] [Google Scholar]
  8. GORE I. Disseminated arteriolar and capillary platelet thrombosis; a morphologic study of its histogenesis. Am J Pathol. 1950 Jan;26(1):155-75, incl 4 pl. [PMC free article] [PubMed] [Google Scholar]
  9. HAUSER A., BEYER A., Jr, BURGER R. A. Encephalopathy associated with acute diffuse platelet thrombosis; report of a case. AMA Arch Neurol Psychiatry. 1951 Jun;65(6):672–682. doi: 10.1001/archneurpsyc.1951.02320060015002. [DOI] [PubMed] [Google Scholar]
  10. HELLSTROM H. R., NASH E. C., FISHER E. R. Thrombotic thrombocytopenic purpura as a cause of massive gastrointestinal hemorrhage; report of a case. Gastroenterology. 1959 Jan;36(1):132–136. [PubMed] [Google Scholar]
  11. LADWIG H. A. The central nervous system in thrombotic thrombocytopenic purpura. Neurology. 1953 Apr;3(4):267–276. doi: 10.1212/wnl.3.4.267. [DOI] [PubMed] [Google Scholar]
  12. MARCH H. W. The diffuse vascular lesion of so-called thrombotic thrombocytopenic purpura. Circulation. 1954 Jul;10(1):43–55. doi: 10.1161/01.cir.10.1.43. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. ORBISON J. L. Morphology of thrombotic thrombocytopenic purpura with demonstration of aneurysms. Am J Pathol. 1952 Jan-Feb;28(1):129–143. [PMC free article] [PubMed] [Google Scholar]
  15. SHARNOFF J. G., KIM E. S. Evaluation of pulmonary megakaryocytes. AMA Arch Pathol. 1958 Aug;66(2):176–182. [PubMed] [Google Scholar]
  16. STUART A. E., MACGREGOR-ROBERTSON G. Thrombotic thrombocytopenic purpura; a hyperergic micro-angiopathy. Lancet. 1956 Apr 21;270(6921):475–479. [PubMed] [Google Scholar]
  17. SYMMERS W. S. C., BARROWCLIFF D. F. Platelet thrombosis syndrome. J Pathol Bacteriol. 1951 Jul;63(3):552–554. [PubMed] [Google Scholar]
  18. SYMMERS W. S. Thrombotic microangiopathy (thrombotic thrombocytopenic purpura) associated with acute haemorrhagic leucoencephalitis and sensitivity to oxophenarsine. Brain. 1956 Sep;79(3):511–521. doi: 10.1093/brain/79.3.511. [DOI] [PubMed] [Google Scholar]

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