BACKGROUND Cotton wool spots are known to be a complication in patients with thrombotic thrombocytopenic purpura or with polymyositis. CASE A 53-year-old woman developed numerous cotton wool spots around the optic disc of both eyes. OBSERVATIONS Fluorescein angiography disclosed capillary obstruction and microaneurysms in the early phase, followed by dye leakage in the late phase. Systemica...

The cause of platelet agglutination in thrombotic thrombocytopenic purpura has been an enigma. Current evidence indicates that the interaction of platelets with a platelet-aggregating factor or unusually large multimers of factor Vlllrvon Willebrand factor, or both, may cause the abnormal platelet agglutination. Recent success in the treatment of thrombotic thrombocytopenic purpura with intrave...

Thrombotic microangiopathy (TMA) is a known complication of HIV infection. Endothelial cell injury appears to be the primary event causing platelet activation and deposition in the microvasculature. Direct cytopathic roles of HIV as well as other factors such as malignancy, drugs, and infectious agents have been implicated in the pathogenesis of HIV-TMA. Although the the majority of patients pr...

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare clinical entity where tumor cell embolisms in pulmonary circulation induce thrombotic microangiopathy (TMA), respiratory failure, and subacute cor pulmonale. We describe 3 cases of PTTM that presented as the initial manifestation of metastatic gastric adenocarcinoma with TMA and pulmonary infiltrates. All 3 cases had similar clinical a...

Thrombotic microangiopathy comprises a spectrum of clinical and lab findings including microangiopathic hemolytic anemia, thrombocytopenia, and thrombosis of capillary and arterioles. Platelet and hyaline thrombi with complete or partial occlusion of these vessels are integral histopathological findings. These findings are seen irrespective of cause and organ involved. Pathogenesis and prognosi...

One of every three patients with deep-vein thrombosis of the lower extremities will develop, within 5 years, post-thrombotic sequelae that vary from minor signs to severe manifestations such as chronic pain, intractable edema, and leg ulceration. The post-thrombotic syndrome (PTS) develops as a result of the combination of venous hypertension due to persistent outflow obstruction or valvular in...

Non-bacterial thrombotic endocarditis (NBTE) is a disease characterised by the presence of vegetations on cardiac valves, which consist of fibrin and platelet aggregates and devoid of inflammation or bacteria. NBTE has increasingly been recognised as a condition associated with numerous diseases and a potentially life-threatening source of thromboembolism. NBTE is not a common entity; however i...

The thrombotic microangiopathies (TMA) are a group of common microvascular occlusive disorders characterized by thrombocytopenia, microangiopathic hemolysis and multiorgan dysfunction. The pathological features are vascular damage manifested by arteriolar and capillary thrombosis with characteristic abnormalities in the endothelium and vessel wall. Pregnancy associated TMA is a life threatening...

CHRONIC, massive thrombotic obstruction of the pulmonary arteries has attracted interest recurrently through the years as a neglected cause of pulmonary hypertension of obscure etiology, usually discovered at autopsy.'-10 This form of "cor pulmonale" has been regarded as a rare entity of academic rather than therapeutic interest. Such opinions now require revision. With the advent of pulmonary ...

A 6-year-old boy presented with microangiopathic hemolytic anemia, thrombo-cytopenia, altered sensorium and intractable bleeding. A diagnosis of thrombotic thrombocytopenic purpura was made and the child recovered dramatically after plasmapheresis. Recent developments in the understanding of TTP are reviewed, including the importance of a metaloprotease required to cleave multimers of von Willi...