Thrombotic thrombocytopenic purpura following transurethral resection of the prostate.

A 65-year old man developed anaemia, profound thrombocytopenia and acute renal failure 2 days after transurethral resection of the prostate. Based on the clinical picture and blood film evidence of microangiopathic haemolysis, thrombotic thrombocytopenic purpura was diagnosed. The patient was treated with a course of plasma exchange, renal replacement therapy and methylprednisolone and made a good recovery.

Successful repair of a giant abdominal aortoiliac aneurysm in a Jehovah's Witness.

We report the case of a 76-year-old man of the Jehovah's Witness faith who had a giant abdominal aortoiliac aneurysm that was successfully operated on using an aortoiliac Y-graft bypass technique, without the use of stored allogenic blood. Cell saver technique and recombinant human erythropoietin (epoetin beta) were used during the perioperative period. The patient had good postoperative care with a multidisciplinary approach.

Early cytokine response to multiple injury.

Serial measurements of the inflammatory cytokines interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF alpha) were made in four patients with multiple injuries to characterize secretion patterns and to relate them to severity of injury and degree of haemorrhage. IL-6 and TNF alpha were assayed using a sandwich ELISA. Injury scores varied from 9 to 50, and transfusion requirements varied from 7 to 14 units.