THROMBOTIC THROMBOCYTOPENIC PURPURA AND HIV-INFECTION

We report on a man who was HIV-seropositive and who was initially admi tted following multiple episodes of syncope, He gradually developed fu lminant thrombotic thrombocytopenic purpura (TTP). Twenty-one patients with TTP who were HIV-positive have been reported previously, Of thes e 22 patients, all treated with plasmapheresis, 7 died from TTP and 3 suffered relapse but eventually recovered, Delay in initiating plasmap heresis may be fatal, We have correlated the laboratory data of these patients at time of admission with subsequent clinical outcome; only t he platelet count correlated with outcome, Patients with lower platele t counts were less likely to relapse or die with therapy, Physicians c aring for patients: infected with HIV should always consider the possi bility of TTP in those patients with thrombocytopenia of unknown etiol ogy, Review of the peripheral blood smear, allowing the detection of m icroangiopathic hemolytic anemia, is an important clue, enabling one t o consider the correct diagnosis.