HIV-RELATED THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP) AS FIRST CLINICAL MANIFESTATION OF INFECTION

A case of thrombotic thrombocytopenic purpura (TTP) in a 40-year-old b isexual man unaware of being HIV positive is reported. The hematologic syndrome represented the first clinical manifestation of this viral i nfection. The clinical picture, characterized by severe hemolytic micr oangiopathic anemia, thrombocytopenia, fluctuating neurologic abnormal ities and fever, quickly improved after plasma exchange and corticoste roid therapy. Two blood tests showed severe depletion of the CD4+ lymp hocyte count and HN antigenemia was positive. This case represents a c linical epiphenomenon of HIV infection in an advanced phase. According to recent CDC criteria the patient should be considered in AIDS. Anti retroviral treatment was started and after nine months of follow-up th ere has been no relapse.