THROMBOTIC THROMBOCYTOPENIC PURPURA ASSOCIATED WITH HIV AND VISCERAL KAPOSIS-SARCOMA TREATED WITH PLASMAPHERESIS AND CHEMOTHERAPY

We present a case of a patient who is HIV positive and developed both thrombotic thrombocytopenia purpura and visceral Kaposi's sarcoma (KS) with hemorrhage, This case presents a difficult management problem in that the patient's bleeding originated from KS lesions and did not qu ickly abate with plasmapheresis therapy despite both clinical and labo ratory improvement after 2-4 days. Chemotherapy was initiated on day 1 3 and the patient's condition improved markedly afterward. We believe the addition of chemotherapy to plasmapheresis hastened the improvemen t of our patient's thrombotic thrombocytopenic purpura (TTP) and KS-re lated bleeding. Therefore, under similar conditions, we recommend comb ining plasmapheresis and chemotherapy at the onset of therapy. (C) 199 8 Wiiey-Liss, Inc.dagger.