The Oklahoma Thrombotic Thrombocytopenic Purpura– Hemolytic Uremic Syndrome Registry: the Swiss connection

Thrombotic thrombocytopenic purpura (TTP) has a dra-matic history beginning with the initial reports by Mos-chcowitz in 1924 and 1925 (1, 2). The description of all 271 reported cases through 1964 defined its natural his-tory (3). In this era before effective treatment, 90 % of patients died, some rapidly, as the original case (1, 2), others developing multi-organ failure over months (3). A pentad of clinical features, present in 88–98 % of patients in the 1966 review (Table 1), was described as the char-acteristic clinical presentation and appropriate diagnostic criteria: thrombocytopenia, microangiopathic hemolytic anemia, neurologic abnormalities, renal failure, and fever (3). With the introduction of effective plasma therapy after 1970, there was more urgency for diagnosis requir-ing less stringent diagnostic criteria, apparent in a revie