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Thrombotic Thrombocytopenic Purpura and Hemolytic-Uremic Syndrome in HLA-Identical Siblings

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The authors thank Dr. Eugene Heise, Department of Microbiology and Immunology, Bowman Gray School of Medicine, for tissue-typing of this family and Carol Johnson for secretarial assistance.

Bowman Gray School of Medicine; Winston-Salem, North Carolina

Ann Intern Med. 1980;93(2):283-284. doi:10.7326/0003-4819-93-2-284
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Thrombocytopenia, microangiopathic hemolytic anemia, and renal failure are features common to both hemolytic-uremic syndrome and thrombotic thrombocytopenic purpura, with neurologic disturbances being more frequently observed in the latter disorder. The causes of these syndromes are unknown. Neither the occurrence of hemolytic-uremic syndrome and thrombotic thrombocytopenic purpura in the same family nor tissue-typing using the HLA system in siblings with these disorders has been previously reported. The cases described below occurred 6½ years apart in HLA-identical brothers. Although features of these two cases appear sufficiently different to allow separation into thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome, the unique occurrence in brothers


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