Early diagnosis of thrombotic microangiopathy by paraffin sections of aspirated bone-marrow.

Blecher, T. E.; Raper, A. B.

doi:10.1136/adc.42.222.158

Cited by 9 publications

(2 citation statements)

References 20 publications

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“…Hence, no case can be accepted as a TTP paradigm which discloses fibrinoid necrosis or vasculitis in the vessel walls. A variety of tissues have been successfully used in biopsies, including bone marrow [19], lymph node [6,119], kidney, gingiva [74], and skin. Skin tissue biopsy is preferable [see pages [188][189][190] if examined carefully microscopically through the region of the petechiae, because the inevitable bleeding is most easily controlled in the skin.…”

Section: Laboratory Features Of the Ttp Paradigmmentioning

confidence: 99%

Thrombotic Thrombocytopenic Purpura: An Extended Editorial

Nalbandian¹,

Henry²,

Bick³

2008

Semin Thromb Hemost

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Mystery and perplexity have burdened the history of TTP. The etiology of this disease remains unknown. The pathogenesis has been an enigma. No specific diagnostic test has yet been devised. The diagnosis is made tentatively and with imprecision. The tissue pathologic features are not at all pathognomonic. The laboratory findings are interchangeable with numerous other entities. The treatment is in perpetual debate. This regrettable catalogue of flawless failure also records that a strong clue for life-saving treatment in this deadly disease has been overlooked for half a century, until recent times.We propose new discriminatory, diagnostic standards for the identification of thrombotic thrombocytopenic purpura (TTP). Only by the use of a stringently defined paradigm applied prospectively to TTP will it be possible to understand the pathogenesis, to improve diagnostic accuracy, and especially to evaluate reliably the efficacy of a growing list of therapies. The diagnosis of TTP is in confusion and must be put right.The bleak record of progress in TTP is best regarded as bristling with opportunities for discovery. Continuing investigations by Kwaan [93,96, this issue, and recent discoveries by Byrnes and co-workers [35-37,101, this issue, pages 199-215] have given us invaluable insights into pathogenesis and treatment respectively. Suddenly, we are hopeful that some of our ignorance about TTP will soon vanish.The Byrnes' group has reported that plasma transfusions constitute effective, life-saving treatment in TTP [this issue pages [204][205][206]. This boon, however, is coupled with a hazard. Since TTP is rare, no single group may acquire any substantial clinical experience with the disease. Furthermore, diagnostic criteria for TTP are so non-specific, that more than TTP is so labeled. Thus, a proposed therapy for authentic cases of TTP will appear to be ineffective when inappropriately applied also to cases simulating

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Section: Laboratory Features Of the Ttp Paradigmmentioning

confidence: 99%

Thrombotic Thrombocytopenic Purpura: An Extended Editorial

Nalbandian¹,

Henry²,

Bick³

2008

Semin Thromb Hemost

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“…7 Tissue biopsies have also been used to aid in the diagnosis of TTP. These include bone marrow biopsies [8][9][10] and skin biopsies. 11 The identification of the microvascular lesions in these biopsies is not always successful and biopsies are no longer used in clinical practice at present.…”

Section: The Microvascular Lesionmentioning

confidence: 99%

The Clinical Spectrum of Thrombotic Thrombocytopenic Purpura

Kwaan

Boggio²

2005

Semin Thromb Hemost

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The clinical syndrome of fever, neurologic abnormalities, renal impairment with laboratory findings of thrombocytopenic and microangiopathic hemolytic anemia is seen in thrombotic thrombocytopenic purpura (TTP) and a variety of disorders associated with thrombotic microangiopathy (TMA). With improved understanding of the pathogenesis of the perturbed metabolic pathway of von Willebrand factor in TTP, the classic Moschcowitz syndrome, now more accurately referred to as idiopathic TTP, can be distinguished from other TMAs. The distinguishing features are useful not only in providing an accurate diagnosis but also help to determine the best therapeutic strategy.

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Thrombotic Thrombocytopenic Purpura

Silverstein¹

1968

Arch Neurol

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Early diagnosis of thrombotic microangiopathy by paraffin sections of aspirated bone-marrow.

Cited by 9 publications

References 20 publications

Thrombotic Thrombocytopenic Purpura: An Extended Editorial

Thrombotic Thrombocytopenic Purpura: An Extended Editorial

The Clinical Spectrum of Thrombotic Thrombocytopenic Purpura

Thrombotic Thrombocytopenic Purpura

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