{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T07:51:21Z","timestamp":1789977081243,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,2,6]],"date-time":"2007-02-06T00:00:00Z","timestamp":1170720000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2007,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Several case reports have suggested an association between infections and thrombotic thrombocytopenic purpura (TTP). In Case 1, a 37\u2010year\u2010old female presented with TTP 6 times over 7 years, requiring 242 therapeutic plasma exchanges (TPE), for a per\u2010course range of 4\u201357 TPE (median 48), and treatment durations of 4\u2013241 days (median 71 days), largely on account of multiple exacerbations (range 0\u20133, median 3). Twelve of 17 (71%) of her presentations or exacerbations were associated with suspected infections, with confirmation in 9 episodes. These included pulmonary TB, CMV pneumonitis, mucocutaneous HSV, ventilator\u2010associated or urinary tract\u2010associated gram\u2010negative sepsis, central line\u2010associated staphylococcal bacteremia, and cellulitis. Except for TB, all infections occurred after splenectomy, which had been performed on day 33 of presentation 1. In Case 2, a 24\u2010year\u2010old female presented with TTP 3 times over 15 months. Her courses were managed with brief courses of TPE (5\u201311 treatments per course, median 5). Suppressed ADAMTS13 levels due to inhibitors were confirmed twice. Presentation 1 was antedated by atypical community acquired pneumonia. Presentation 3 (and possibly 2) followed prolonged, progressive, antibiotic\u2010refractory periodontal infections ultimately requiring exodontic surgery. Our cases add to a literature that suggests that infection may be associated with exacerbations or relapses of TTP in some patients. Our patients demonstrated repeated TTP exacerbations in association with different infectious agents. A better understanding of the possible relationship between infection and clinical expression of TTP might lead to improved treatment decisions for patients with this complex illness. J. Clin. Apheresis. 22:, 2007 \u00a9 2007 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/jca.20114","type":"journal-article","created":{"date-parts":[[2007,2,6]],"date-time":"2007-02-06T21:27:10Z","timestamp":1170797230000},"page":"21-25","source":"Crossref","is-referenced-by-count":32,"title":["Do infections provoke exacerbations and relapses of thrombotic thrombocytopenic purpura?"],"prefix":"10.1002","volume":"22","author":[{"given":"Christine M.","family":"Cserti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Landaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Uhl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,2,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811263392202"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/1096-8652(200011)65:3<251::AID-AJH13>3.0.CO;2-2"},{"key":"e_1_2_1_4_2","first-page":"387","article-title":"Inhibitors of von Willebrand factor\u2010cleaving protease in thrombotic thrombocytopenic purpura","volume":"47","author":"Tsai HM","year":"2001","journal-title":"Clin Lab"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-01-0193"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05512.x"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1614780"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01710061"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.10.1347"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199806270-00018"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2004.00224.x"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2005.06.015"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2000.40091067.x"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-0968.2003.00016.x"},{"key":"e_1_2_1_15_2","first-page":"4","article-title":"Association of thrombotic thrombocytopenic purpura and urinary tract infection","volume":"21","author":"Schultz EF","year":"2006","journal-title":"J Clin Apheresis"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1998.38598297208.x"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2004.00617.x"},{"key":"e_1_2_1_18_2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1001\/archinte.1981.00340050131031","article-title":"Recurrent thrombotic thrombocytopenic purpura after viral infection. 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