Thrombotic thrombocytopenic purpura associated with rapidly progressive lupus nephritis: report of two cases

There are a few reported cases in the literature of thrombotic thrombocytopenic purpura (TTP), associated with systemic lupus erythematosus (SLE). We describe two cases of TTP which have been presented during rapidly progressive lupus nephritis, with grand-mal seizures, thrombocytopenia and microangiopathic hemolytic anemia. Both cases were treated with hemodialysis, plasma exchange, corticosteroids, cyclophosphamide and intravenous gamma-globulin. In both cases the TTP was improved but not the renal function. Further experience is needed to determine whether intensive and prompt treatment with plasma exchange, corticosteroids and chemotherapy leads to a favorable outcome, in cases of TTP associated with SLE.