• Intravascular platelet deposition has been considered an essential pathophysiologic mechanism in thrombotic thrombocytopenic purpura. Splenectomy resulted in prompt and sustained hematologic improvement in a patient with the chronic form of the disease. The response to splenectomy, normal plasma levels of secretable platelet proteins, and phagocytosis of erythrocyte fragments and platelets by splenic macrophages demonstrated by electron microscopy suggest that platelet destruction may occasionally be predominantly extravascular in this disease.
(Arch Intern Med 1985;145:937-939)