Severe hemolytic anemia and thrombocytopenia developed in a 56-year-old man with Laennec's cirrhosis. Rather than having one or more of the expected causes for these problems associated with cirrhosis, he proved to have acute thrombotic thrombocytopenic purpura. Treatment with platelet antiaggregant drugs and exchange plasmapheresis was ineffective in controlling the disease. The presence of advanced liver disease may precipitate or complicate this unusual syndrome.

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http://dx.doi.org/10.1001/archinte.139.6.711DOI Listing

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