CLINICAL AND LABORATORY OBSERVATIONSCase Series of Thrombotic Thrombocytopenic Purpura in Children and AdolescentsHorton, Terzah M. M.D., Ph.D.; Stone, Jeffrey D. M.D.; Yee, Donald M.D.; Dreyer, ZoAnn M.D.; Moake, Joel L. M.D.; Mahoney, Donald H. M.D. Author Information From the Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Texas Children's Hospital (T.M.H., J.D.S., D.Y., Z.D., D.H.M.), and the Department of Medicine, Baylor College of Medicine, The Methodist Hospital (J.L.M.), Houston, Texas, U.S.A. Submitted for publication April 18, 2002; accepted July 24, 2002. Address correspondence and reprint requests to Donald H. Mahoney, M.D., Texas Children's Cancer Center, Houston, TX 77030, U.S.A. E-mail: [email protected] Journal of Pediatric Hematology/Oncology: April 2003 - Volume 25 - Issue 4 - p 336-339 Buy Abstract Thrombotic thrombocytopenic purpura (TTP) is a well-described entity in adults but is rarely observed in children. The authors describe a series of seven children with suspected acquired TTP. Clinical findings included petechiae, purpura, or jaundice (6), central nervous system events (5), fever (3), diarrhea (3), renal insufficiency (2), and hematuria (2). Significant central nervous system events included cerebral vascular accidents (2), altered mental status (2), seizures (1), and hemiparesis (1). Patients were treated with daily plasma infusions (1/7) or plasma exchange (5/7). Response was prompt, although relapses were frequent. Decreased vWF-protease activity was found in four of five cases and vWF-protease inhibitors were found in three of five cases. Although rare, TTP is a life-threatening illness that does occur in children and should be considered in the differential diagnosis of thrombocytopenia with hemolytic anemia. © 2003 Lippincott Williams & Wilkins, Inc.