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Volume 355:630 August 10, 2006 Number 6
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Thrombotic Thrombocytopenic Purpura

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by George, J. N.
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To the Editor: In his review of the diagnosis and treatment of thrombotic thrombocytopenic purpura (May 4 issue),1 Dr. George did not mention acetylsalicylic acid, or aspirin. Platelet activation leading to microvascular thrombi is the main pathologic feature of thrombotic thrombocytopenic purpura. Consequently, it is logical to complement plasma exchange and corticosteroids with inhibitors of platelet function. For this reason, aspirin was part of the standard treatment protocols in the two largest studies of plasma exchange.2,3 There have been reports of sudden deterioration and death among patients with thrombotic thrombocytopenic purpura during recovery thrombocytosis because they were not taking platelet . . . [Full Text of this Article]



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