Thrombotic thrombocytopenic purpura (TTP) is a disorder of unknown etiology. An immunologic basis has been suggested, although proof is lacking. The immunologic, hematologic, and autopsy findings in a case of TTP occurring 6 wk postpartum are described. Immunofluorescent studies revealed the presence of IgM and complement, as well as fibrin in the vicinity of the endothelium and in thrombi in small blood vessels in multiple organs. These findings suggest an active immunologic process in this case. While TTP is probably of diverse etiology, confirmation of these findings in further cases would provide a rational basis for the use of immunosuppressive therapy.

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