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Pathology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

In TTP there is aggregation of platelets that obstruct reversibly the arterioles and capillaries of various organs resulting in fluctuating ischaemia (and sometimes infarction).

Features include:

  • brain is involved in 50-71% of cases
  • early capillary and arteriolar microthrombi in TTP consist almost exclusively of microthrombi without perivascular inflammation
  • TTP is associated with excessive release of ULvWF multimeric forms from systemic endothelial cells. If these endothelial cells are perturbed transiently then a single-episode of TTP occurs; if perturbed periodically then intermittent TTP occurs
  • immunohistochemical studies in thrombi in TTP have revealed:
    • an abundance of von Willebrand factor
    • little fibrinogen/fibrin
    • both are opposite findings to those seen in thrombotic lesions in DIC

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