Relapsing thrombotic thrombocytopenic purpura in association with recurrent pancreatitis

We report the case of a 28-year-old woman who presented with two episodes o f acute pancreatitis 3 years apart both of which were complicated by the de velopment of thrombotic thrombocytopenic purpura (TTP), On each occasion th e TTP was successfully managed with plasmapheresis, Although TTP has been r eported as causing acute pancreatitis, the induction of TTP by pancreatitis is rare, As far as we are aware this is the first reported case of recurre nt TTP in association with acute pancreatitis. It is possible that circulat ing pancreatic proteases may have induced the TTP by modifying von Willebra nd factor enabling spontaneous platelet membrane receptor binding resulting in intravascular platelet aggregation.