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July 1958

Thrombotic Thrombocytopenic Purpura Occurring in the Puerperium: Associated Pancreatic Islet-Cell Necrosis

Author Affiliations

U. S. Army (Res.)

AMA Arch Intern Med. 1958;102(1):124-130. doi:10.1001/archinte.1958.00260190126014

Thrombotic thrombocytopenic purpura occurring in the puerperium has not been described previously in the literature. For this reason and the fact that there was an associated selective pancreatic islet-cell necrosis which presented initially as a surgical problem, it is reported at this time.

The disease was first described by Moschowitz,1 in 1925, and to date approximately 70 cases have been published in the literature under various names, including generalized platelet thrombosis,2 thrombocytic achroangiothrombosis,3 and thrombocytopenic verrucal angionecrosis.4

Thrombotic thrombocytopenic purpura is an acute fatal disease of unknown etiology characterized clinically by the deficiency of platelets, hemolytic anemia, neurologic findings, and a low-grade fever. The diagnostic pathological feature is the presence of numerous occlusive mound-like lesions in the arterioles and capillaries of most internal organs, particularly the heart, adrenal, and pancreas.

Originally there was thought to be a female sex predominance,3 but this has not been

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