Thrombotic Thrombocytopenic Purpura (TTP) and Splenectomy

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Abstract
TTP is a disease process characterized by microangiopathic anemia, fever, neurologic manifestations, renal abnormalities and thrombocytopenia. These clinical findings are caused by vascular occlusions of the microcirculation. At present the utilization of splenectomy in the treatment of this illness remains a highly controversial subject. Review of the literature reveals that 70% of the long-term survivors of TTP had undergone splenectomy. Patients (5) with TTP, 4 of whom were splenectomized are studied. Long-term survival (> 1 yr) was achieved in 3 individuals. Splenectomy should be considered as part of the initial management of all patients with TTP, in addition to high dose corticosteroids and antiplatelet drugs.