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Letters |1 June 1997

Splenectomy for Relapsing Thrombotic Thrombocytopenic Purpura

Lawrence Rice, MD

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  • Baylor College of Medicine, Houston, TX 77030
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TO THE EDITOR:
My colleagues and I were the first to point out that as more patients survived their initial episode of thrombotic thrombocytopenic purpura, relapses were not rare but rather might afflict more than one third of patients [1]. Our experience impels me to question on two counts the value of splenectomy purported by Crowther and colleagues [2].
First, we have seen several patients with a pattern of relapses over a few years who spontaneously cease experiencing relapses. Thus, any intervention (or nonintervention) in such patients, who were preselected for frequent relapses, would seem to result in a lower rate of subsequent relapses. Pertinent examples are a middle-aged woman and a 60-year-old man who each had four episodes of thrombotic thrombocytopenic purpura over 6 years. Neither patient had any further episodes over several years. If splenectomy had been done for the first patient, it would seem to have been highly effective in preventing relapses. The second patient actually underwent splenectomy during the first episode!
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Rice L. Splenectomy for Relapsing Thrombotic Thrombocytopenic Purpura. Ann Intern Med. 1997;126:915. doi: 10.7326/0003-4819-126-11-199706010-00013

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Published: Ann Intern Med. 1997;126(11):915.

DOI: 10.7326/0003-4819-126-11-199706010-00013

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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