Gingival Biopsy in Thrombotic Thrombocytopenic Purpura
Annals of Internal MedicinePublished 1 October 1978
A. Goodman, ROCHE RAMOS, MARY PETRELLI, STANLEY A. HIRSCH, RONALD BUKOWSKI, JOHN W. HARRIS
Citations31
SJR quartileQ1
SJR score3.38
SNIP3.27
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
It is concluded that gingival biopsy inThrombotic thrombocytopenic purpura, although helful in confirming the diagnosis, is less often positive than has been suggested and should be avoided.
Abstract
Gingival biopsy has been advocated as a readily available, safe, rapid histologic confirmation of the clinical diagnosis of thrombotic thrombocytopenic purpura. Eighteen gingival biopsies from 16 patients with proven thrombotic thrombocytopenic purpura were reviewed. Seven (39%) showed characteristic histologic changes: [1] subendothelial hyalinelike deposits; [2] intraluminal deposits; [3] lack of inflammatory change in vessels and stroma. To assess specificity, gingival sections from 154 patients with oral pathology only and from 50 unselected autopsies were reviewed: 10% to 20% of biopsies from patients with oral pathology only (primarily inflammation) and three of 50 autopsy specimens showed occasional intraluminal deposits but no subendothelial deposits. In addition, other histologic features permitted them to be distinguished from thrombotic thrombocytopenic purpura. We conclude that gingival biopsy in thrombotic thrombocytopenic purpura, although helful in confirming the diagnosis, is less often positive than has been suggested. Biopsy of grossly inflamed gingiva should be avoided.
Keywords
Immunology and MicrobiologyMedicine
New England Journal of MedicineTreatment of Thrombotic Thrombocytopenic Purpura with Plasma
363 Citations1977John Byrnes, Mohan Singh Khurana
Since the pathogenesis of this disease is not understood, treatment has been empirical or with an assumed rationale, among the various modes of therapy tried, four are especially advocated: splenectomy and use of antiplatelet agents, of high doses of glucocorticoids, and of exchange transfusions.
BloodPlasmapheresis in the treatment of thrombotic thrombocytopenic purpura
265 Citations1977RM Bukowski, JW King +1 more
Human PathologyPathology of disseminated intravascular coagulation (DIC)
164 Citations1972Stanley J. Robboy, Melissa Major +2 more
The location and severity of fibrin thrombi, the types of vessels affected, skin biopsy as a diagnostic procedure, unusual syndromes of disseminated intravascular coagulation, consequences of major vessel thromboses, and complications intrinsic to the disorder or those induced inadvertently by therapy are presented.
New England Journal of MedicineIsolation of a Microtatobiote from Patients with Hemolytic-Uremic Syndrome and Thrombotic Thrombocytopenic Purpura and from Mites in the United States
96 Citations1969N Mettler
The findings support the view that there is an etiologic relation between the agent isolated from two patients with hemolytic-uremic syndrome and the disease in the cases reported.
Annals of Internal MedicineAntiplatelet Treatment of Thrombotic Thrombocytopenic Purpura
83 Citations1977Edward L. Amorosi, SIMON KARPATKIN
In the 50 years since its first description, some aspects of the pathogenesis of thrombotic thromBocytopenic purpura have been clarified, but its etiologic definition and the developmen...
JAMAThrombotic Thrombocytopenic Purpura-like Syndrome Associated With Infective Endocarditis
64 Citations1977Arnold S. Bayer
A thrombotic thrombotic thrombocytopenic purpura (TTP)-like syndrome was the chief presenting feature in two patients with infective endocarditis and an immunopathologic mechanism may have been operative.
JAMAThrombotic Thrombocytopenic Purpura
63 Citations1976Wolfgang Fuchs
The occurrence of the classical syndrome of fatal TTP in two sisters began suddenly, near the end of her first pregnancy: one in September 1972, the other in September 1974.
Annals of Internal MedicineThrombotic Thrombocytopenic Purpura
58 Citations1967Robert G. Lerner, SAMUEL I. RAPAPORT +1 more
JAMAElevated Platelet-Associated IgG in Thrombotic Thrombocytopenic Purpura
58 Citations1977John H. Morrison
Analysis of the patient's platelets for immunoglobulins showed abnormally elevated levels in the range of those seen in thrombocytopenic patients with systemic lupus erythematosus, immune vasculitis, and infectious mononucleosis, consistent with the concept that the immune system may play a role in the pathogenesis of TTP.
BloodTreatment of Thrombotic Thrombocytopenic Purpura With Antiplatelet Drugs
55 Citations1973Jacob Amir, Stephen Krauss
The patient did not respond to splenectomy, corticosteroids, and heparin sodium, but she made a full recovery after antiplatelet drugs (aspirin and dipyridamole) were added to the therapeutic regimen and has now been in full remission more than 12 mo.
American Journal of Obstetrics and GynecologyThrombotic thrombocytopenic purpura associated with pregnancy
53 Citations1976Harry V. May, Guy M. Harbert +1 more
Care must be taken to recognize the pregnancy complicated by TTP, a circumstance which appears to occur more frequently than past reports have indicated.
BloodThrombotic Thrombocy openic Purpura: Report of a Case With Possible Immune Etiology
50 Citations1972Michael J. Mant, Maurice N. Cauchi +1 more
Investigation of the immunologic, hematologic, and autopsy findings in a case of TTP occurring 6 wk postpartum suggest an active immunologic process in this case, which would provide a rational basis for the use of immunosuppressive therapy.
Annals of SurgerySplenectomy for Thrombotic Thrombocytopenic Purpura
49 Citations1969Roger Bernard, Arithur W. Bauman +1 more
BloodThrombotic Thrombocytopenic Purpura: Report of a Case With Disseminated Intravascular Platelet Aggregation
47 Citations1973P. B. Neame, Juan Lechago +2 more
This case shows that the occlusions observed in TTP can be due to disseminated intravascular platelet aggregation in the absence of DIC, and it is felt that cases showing disseminated Intravascular Platelet aggregation should be distinguished from DIC in order to plan therapy on a rational basis.
Archives of Internal MedicineThrombotic thrombocytopenic purpura. Treatment with corticosteroids and splenectomy
45 Citations1968J. Bradford Hill
Three additional living patients treated with large doses of corticosteroids and splenectomy with TTP are reported, and remission of ten, five, and two years' duration have been achieved.
PubMedThrombotic thrombocytopenic purpura: a syndrome of intravascular platelet consumption.
41 Citations1976P. B. Neame, J. Hirsh +5 more
The observations show that TTP is a disorder in which intravascular platelet consumption results in disseminated platelet thrombosis, and the coagulation system is apparently activated secondarily to platelet aggregation and variable quantities of fibrin are incorporated into the thrombi.
JAMAThrombotic Thrombocytopenic Purpura
34 Citations1973Paul B. Goldenfarb
Five of seven patients with thrombotic throm bocytopenic purpura have survived from 1 to 10.5 years from the time of diagnosis, and in two of three cases, bedside biopsy of gingival tissue provided rapid histological confirmation of the clinical diagnosis.
JAMAThrombotic Thrombocytopenic Purpura
28 Citations1968Joseph H. Richardson
A patient withThrombotic thrombocytopenic purpura complicating pregnancy survived and was attributed to heparin sodium therapy.
JAMAThrombotic Thrombocytopenic Purpura
26 Citations1971Charles G. Watson
The concurrence of this disease in husband and wife, reported herein, further suggests an etiology of environmental origin.
American Journal of Clinical PathologyThrombotic Thrombocytopenic Purpura with C′<sub>3</sub>Vascular Deposits: Report of a Case
25 Citations1977Dennis D. Weisenburger, Michael L. O’Conner +1 more
IgM and complement were demonstrated in capillary and small arteriole walls by immunofluorescent microscopy, supporting the findings of a previous case report and providing further evidence for a possible primary immune etiology for thrombotic thromBocytopenic purpura.
Annals of Internal MedicinePhagocytosis of Blood Cells by Splenic Macrophages in Thrombotic Thrombocytopenic Purpura
25 Citations1975Albert Kadri, M. MOINUDDIN +1 more
Imprints from the cut surface of the spleen showed marked phagocytosis of all the cellular elements of the blood, suggesting that hypersplenism, in addition to vascular occlusion, may play a major role in the physiopathology of some cases of thrombotic throm bocytopenic purpura.
Annals of Internal MedicineThe Treatment of Acute Thrombotic Thrombocytopenic Purpura with Corticosteroids and Splenectomy
20 Citations1966Ariel Distenfeld, ELLIOTT OPPENHEIM
Excerpt Since Moschowitz published the first description of thrombotic throm bocytopenic purpura in 1925, case reports of this entity have appeared with increasing frequency in the medical liter...
BloodAbnormal Fibrinogen in Thrombotic Thrombocytopenic Purpura
9 Citations1968I Rivero, Norton D. Ritz
Thrombotic thrombocytopenic purpura may be associated with incomplete in vivo defibrination and a circulating partially degraded fibrinogen and a patient with this syndrome is alive and well forty months after treatment with 200 mg of prednisone daily.
PubMedDiabetes insipidus complicating thrombotic thrombocytopenic purpura.
7 Citations1969Ellis J. VanSlyck, J C Jurgensen +1 more
The LancetTHROMBOTIC THROMBOCYTOPENIC PURPURA PRESENTING WITH GYNÆCOLOGICAL MANIFESTATIONS
7 Citations1973William E. Mitch, Donald B. Spangler +2 more
The presence of fibrin split products in the serum of three patients suggested the presence of disseminated intravascular coagulation, which is a common problem in T.T.P.
JAMADiabetes Insipidus Complicating Thrombotic Thrombocytopenic Purpura
5 Citations1969Ellis J. VanSlyck
Archiv für Pathologische Anatomie und Physiologie und für Klinische MedicinMoschcowitz syndrome with involvement of the central nervous system
5 Citations1975P. Pilz
The origin of hemolytic anemia, the histogenesis of vascular changes and the origin of prethrombotic lesion are dicussed in a typical case of throm botic thrombocytopenic purpura (TTP) with early neurological symptoms.