Thrombotic Thrombocytopenic Purpura: Failure of Plasma Infusion and Antiplatelet Agents

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To the editor: Byrnes and Khurana (1) have reported the successful treatment of patients with thrombotic thrombocytopenic purpura using plasma infusions. Different promising treatments have been advocated by other authors, yet the mortality rate continues at about 70%. No regimen has been shown by controlled trials to be more effective than any other method.

A 23-year-old woman with juvenile onset diabetes noted easy bruising 2 days before hospital admission for asymptomatic mild jaundice. Examination showed a temperature of 37.4 °C, petechiae and ecchymosis, mild scleral icterus, and a barely palpable nontender liver. Neurologic findings were normal. Laboratory findings included a

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