Abstract
A 34-year-old Japanese woman consulted a doctor with complains of nasal bleeding, irregular genital bleeding and subcutaneous petechiae about 16 years before her death. Initially, she was suspected of ITP with anti-platelet antibody, but 15 years later, diagnosed as SLE.
At autopsy, microscopic examination revealed hyaline thrombi-like subendothelial deposits in small vessels of the heart, brain, lungs, kidneys and adipose tissues surrounding pancreas, adrenal glands and the right third rib, indicating the presence of TTP. Other major findings were lobular glomerulonephritis, onion-skin lesions of splenic arteries and Libman-Sacks endocarditis.
The pathogenesis of TTP, with special reference to immunohistochemical examinations and anti-platelet antibody, is discussed in the light of the literature.
