Thrombotic Thrombocytopenic Purpura : A Disseminated Disease of Arterioles

1. Two patients with a syndrome of hemolytic anemia, thrombocytopenic purpura and arteriolar occlusions are described.

2. In one patient, a long remission followed splenectomy, and improvement for ten days followed the administration of ACTH. No claim is made that either form of therapy induced the remission, but trial of these procedures in other cases is indicated.

3. Evidence is presented that the primary vascular lesion is a degenerative process in the arteriolar and capillary walls rather than thrombus formation in the lumen of the vessel. The occurrence of aneurysms in arterioles and precapillanes was a striking observation.

4. The histologic changes suggest a relationship to the so-called collagen group of diseases.

5. It is suggested that the term, thrombotic thrombocytopenic purpura, be retained until further study of the conditions permits application of a more suitable name.