An abnormal fibrinogen was demonstrated in the plasma of an eleven year old boy with thrombotic thrombocytopenic purpura during the acute disease and during one clinical relapse nine months later. The altered fibrinogen was antigenically similar to normal fibrinogen but migrated more rapidly toward the cathode. The abnormal fibrinogen was incompletely precipitated by ammonium sulfate or heat, but was clottable by thrombin.

Thrombotic thrombocytopenic purpura may be associated with incomplete in vivo defibrination and a circulating partially degraded fibrinogen. A patient with this syndrome is alive and well forty months after treatment with 200 mg. of prednisone daily.

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