Thrombotic thrombocytopenic purpura historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

In 1924, Eli Moschcowitz first describe TTP. In 1960, plasma infusion was introduced as a part of the treatment of a 8-year old patient with chronic anemia and thrombocytopenia by Schulman and colleagues.In 1966, the new criteria for the diagnosis of TTP. In 1978, Upshaw first described the hereditary aspect of the disease which lacked an enzyme in the blood and responded to plasma transfusion. Moschcowitz ascribed the disease.

• In 1924, Eli Moschcowitz first describe TTP with a pentad of presentation (petechiae, anemia, and pallor followed by paralysis and coma) ^[1].
• In 1960, plasma infusion was introduced as a part of the treatment of a 8-year old patient with chronic anemia and thrombocytopenia by Schulman and colleagues ^[2].
• In 1966, the new criteria for the diagnosis of TTP as the “pentad” of clinical and laboratory features was suggested. The criteria included thrombocytopenia, microangiopathic hemolytic anemia (fragmentation of RBCs or schistocytes) in the peripheral blood smear, neurological signs and symptoms, renal failure, and fever .
• In 1978, Upshaw first described the hereditary aspect of the disease which lacked an enzyme in the blood and responded to plasma transfusion ^[3].
• In 1979, Rennard & Abe proposed the use of the name Upshaw-Schulman syndrome to define the disease with these clinical features who responded to plasma infusion ^[4].
• In 1982, the pathogenesis of TTP was fully understood by Moake and colleagues ^[5].
• Moschcowitz ascribed the disease (incorrectly) to a toxic cause. Moschcowitz noted that his 16 year-old patient had anemia; petechiae; microscopic hematuria; and at autopsy, disseminated microvascular thrombi. Since that time, the pathophysiology, etiology, and medical management of TTP has expanded.

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