Thrombotic Thrombocytopenic Purpura in HIV-Infected Patients

Thrombocytopenia is one of the most common hematologic abnormalities seen in patients infected with the human immunodeficiency virus (HIV). Because HIV-infected patients have a higher incidence of immune-related thrombocytopenia, the laboratory and clinical features of thrombotic thrombocytopenic purpura (TTP) may be overlooked and the diagnosis never considered. The clinical course and treatment of these entities are distinctly different. Early diagnosis and appropriate therapy with plasma exchange therapy may be lifesaving. Outcome and survival with TTP may be related to the stage of HIV infection and the severity of immunosuppression at the time of the diagnosis. The effect that highly active antiretroviral therapy (HAART) will have on the incidence of TTP remains to be seen. Reviewed are 7 episodes of TTP that occurred in 5 patients we cared for along with the literature pertaining to this topic.