In 1954, Singer reviewed the subject of thrombotic thrombocytopenic purpura, collecting 55 cases from the literature.1Wile and Sturgeon, in 1956, compiled an additional 19 instances and added 3 case reports in children.2We are aware of an additional 25 reports during the years 1954-1957, bringing the total number of cases to over 1003-27In general the clinical course of this disorder has been most unfavorable, the majority of patients dying within eight weeks of the recognized onset of the disease. In rare instances survival for more than one year has been reported.23,24,26,28,29Several of these patients had atypical manifestations, so that it is difficult to ascertain the time of onset of the disease and the survival time in all of these cases. No well-documented typical case has undergone long-term spontaneous remission, and a variety of therapeutic endeavors has in general failed to influence the course