Thrombotic Thrombocytopenic Purpura

Abstract

THROMBOTIC thrombocytopenic purpura (TTP) is an acute, usually fatal syndrome of unknown etiology, characterized by fever, thrombocytopenia, microangiopathic hemolytic anemia, and central nervous system and renal abnormalities. It is more common in women than men, and in 20 reported cases, the onset was during pregnancy.¹Familial occurrences in siblings²and concomitant occurrence in a husband and wife³have been reported. The hemolytic-uremic syndrome, which may be clinically identical to TTP, has also been reported to occur in families.^4-6 We report here the occurrence of the classical syndrome of fatal TTP in two sisters (Table). In each sister, the disease began suddenly, near the end of her first pregnancy: one in September 1972, the other in September 1974. eralized weakness in the 36th week of her first pregnancy. Four days later, she experienced transient numbness and paresthesias on the left side Report of Cases Case 1.—