Thrombotic Thrombocytopenic Purpura: Report of a Case with Discussion of Its Tinctorial Features

Abstract

The nature of the intra-vascular thrombi encountered in an example of thrombotic thrombocytopenic purpura in a 30-year-old man was studied by various histologic and histochemical technics utilizing platelet masses, fibrin and fibrinoid as controls. The occlusive material encountered in this disease is tinctorially similar to fibrinoid, differing from other control substances in its resistance to tryptic digestion and argyrophilia. This finding is consistent with morphologic observations that the initial change in this disease is an alteration in arteriole walls with subsequent intra-luminal herniation and occlusion. Findings are strongly suggestive that this disease should be included with other examples of so-called collagen diseases. That hypersensitivity may play a role in the pathogenesis of this disease was indicated by the marked eosinophilia encountered in this case. Paper electro-phoretic studies revealed a pattern compatible with a hyper-sensitivity state.