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Thrombotic Thrombocytopenic Purpura: Yesterday, Today, Tomorrow
Author(s) -
McCarthy Leo J,
Dlott Jeffrey S,
Orazi Attilio,
Waxman Daniel,
Miraglia Charles C,
FM Danielson Constance
Publication year - 2004
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1526-0968.2003.00113.x
Subject(s) - medicine , thrombotic thrombocytopenic purpura , etiology , yesterday , ticlopidine , intensive care medicine , aspirin , platelet , clopidogrel , physics , astronomy
Although much has been learned about the pathophysiologic process of thrombotic thrombocytopenic purpura (TTP), both diagnostically and therapeutically, since its initial description by Moschcowitz in 1924, its etiology and treatments remain, in many instances, problematic. Thrombotic thrombocytopenic purpura remains a rare entity whose etiology is usually unknown, but several drugs and infections have now been implicated in its development (i.e. Cyclosporine A, Mitomycin‐C, Ticlopidine, Simvastatin, Lipitor, Plavix, FK 506, Rapamune (sirolimus), HIV). Although its treatment by plasma exchange has gained worldwide acceptance since the late 1970s, the optimal exchange media is not known, nor the volume and duration of exchange therapy, nor appropriate salvage therapy(ies). Without the benefit of randomized controlled trials, its treatment, to a large extent, remains not evidence‐based but ‘eminence‐based’, making the same mistakes with increasing confidence over an impressive number of years.