Hormonal dependent thrombotic thrombocytopenic purpura (TTP)

This report presents the case history of a 27-year-old woman who developed Thrombotic Thrombocytopenic Purpura (TTP) in the 12th week of her first pregnancy. TTP was successfully controlled with plasma infusions. When plasma infusions were tapered off, TTP relapsed and was followed by eclampsia and fetal death. Plasma infusions were reinstituted until 3 d after delivery. She later suffered relapses manifested by falls in platelet count and haptoglobin level coinciding with the use of an oral contraceptive. After stopping the pill, fluctuations in platelet count and haptoglobin level were observed synchronous with the menstrual cycle (cyclic TTP). The case history described provides evidence for hormonal influences in the genesis of TTP.