Ineffectiveness of Aspirin and Dipyridamole in the Treatment of Thrombotic Thrombocytopenic Purpura

Abstract

Platelet-inhibiting drugs are used widely in the treatment of thrombotic thrombocytopenic purpura. Nineteen consecutive patients received various treatments including platelet inhibitors, glucocorticoid drugs, whole blood or plasma exchange transfusions and splenectomy. During treatment with aspirin and dipyridamole in 14 patients, 5 died; 1 had neither new neurologic signs nor worsening thrombocytopenia. Prostacyclin in 1 patient was not beneficial. Serious bleeding complications, including massive upper gastrointestinal hemorrhage, epistaxes or subarachnoid hemorrhage confirmed at autopsy, occurred in 5 of the 19 patients and only during treatment with aspirin and dipyridamole. There is no evidence for the effectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenia purpura. These drugs may increase the risk of serious bleeding complications.