Thrombotic thrombocytopenic purpura in a human immunodeficiency virus (HIV)‐seropositive homosexual man

Abstract

A case of thrombotic thrombocytopenic purpura (TTP) in a human immunodeficiency virus (HIV)-seropositive homosexual man is reported. The patient improved after corticosteroid and plasma exchange therapy was instituted. The case demonstrated most of the classic features of TTP, including histologic evidence of fibrin thrombi in small blood vessels. Atypical features included reduced number of megakaryocytes in the bone marrow and only partial resolution of thrombocytopenia after therapy was begun. An autoimmune thrombocytopenia has been well-characterized in HIV-antibody-seropositive homosexual men. Physicians caring for HIV-seropositive persons should also be aware of a possible association with TTP.

Do infections provoke exacerbations and relapses of thrombotic thrombocytopenic purpura?

“…In 1981, Wasserstein et al described the onset of TTP in a 50-year-old male with presumed epidemic influenza [17]. The association with HIV was described for the first time in 1987 [18] and subsequently has become more firmly established [19]. In individual case reports, TTP has been found in association with herpes zoster [20], cytomegalovirus [9], Mycobacterium tuberculosis [7,8], Streptococcus pneumoniae [21], Mycoplasma pneumoniae [22], Chlamydia pneumoniae [23], and Legionnella pneumophila [24].…”

Cytopenias among ART-naive patients with advanced HIV disease on enrolment to care and treatment services at a tertiary hospital in Tanzania: A crosssectional study

“…55 HIV-associated thrombotic thrombocytopenic purpura (TTP) is an important cause of thrombocytopenia, first described in 1987. 56 HIV is presumed to precipitate TTP through direct endothelial damage, which in turn causes local generation of thrombin and consumption of metaloprotease, 57 and it commonly occurs in patients with advanced HIV disease. 58 TTP is usually characterised by microvascular platelet deposition and thrombus formation in selected organs with eventually thrombocytopenia, fever and haemolytic anaemia, neurological and renal dysfunction, among others.…”

Hemolytic Uremic Syndrome as a Presenting Form of HIV Infection

“…Some of these disor ders are considered to be secondary to HIV infection itself, others are secondary to associated infections and/or its treatment. Thrombotic thrombocytopenic purpura (TTP)/hcmolytic uremic syndrome (HUS) has been re ported in several patients [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] with AIDS, but HUS as the presenting form of HIV infection has not been reported in any patient. We report here a patient who pre sented with acute renal failure due to HUS secondary to occult HIV infection.…”