{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T13:39:52Z","timestamp":1773149992052,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,9,4]],"date-time":"2014-09-04T00:00:00Z","timestamp":1409788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Thrombotic thrombocytopenic purpura (<jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content>) is a rare and potentially fatal disease. Early implementation of therapeutic plasma exchange (<jats:styled-content style=\"fixed-case\">TPE<\/jats:styled-content>) has decreased the mortality rate from &gt;90% to &lt;10%. However, fatalities still occur in these patients. The goal of this study was to characterize the causes of death and related postmortem findings in patients with <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> in the current era of emergent <jats:styled-content style=\"fixed-case\">TPE<\/jats:styled-content> to identify possible areas for improvement in the care of these patients. We analyzed clinical history, laboratory and histopathologic findings, and causes of death of patients with active <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> in clinical remission autopsied at our institution over 22 years. Of 18 patients, 15 had <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> judged to be a cause of death: it was an underlying cause of death in five cases, intermediate in three, and contributing in seven. The most common immediate causes of death were cardiac arrest and myocardial infarction. The most common <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content>\u2010related findings at autopsy were thrombi\/emboli in heart (9), lung (11), brain (3), kidney (7), followed by hemorrhages in heart (7), lung (8), brain (2), kidney (7), and infarcts in heart (5), lung (4), brain (6) and kidney (3). Analysis of the cases with <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> as a cause of death suggests that the mechanism of death is commonly cardiac in origin. Proactive measures to monitor and protect the heart may be beneficial in these patients.<\/jats:p>","DOI":"10.1111\/1744-9987.12191","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T05:27:36Z","timestamp":1409894856000},"page":"87-92","source":"Crossref","is-referenced-by-count":32,"title":["Cardiac Injury Is a Common Postmortem Finding in Thrombotic Thrombocytopenic Purpura Patients: Is Empiric Cardiac Monitoring and Protection Needed?"],"prefix":"10.1111","volume":"19","author":[{"given":"Larry","family":"Nichols","sequence":"first","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian A","family":"Rollins\u2010Raval","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay S","family":"Raval","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center"},{"name":"The Institute for Transfusion Medicine  Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-009-0478-z"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811263392202"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811263392203"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-009-0476-1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2011.049676"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108083250604"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20240"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4045\/tidsskr.11.0427"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21248"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-01-0193"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23106"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20731"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5858\/2003-127-834-TTPAHU"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290420035022"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-65-1-37"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-91-3-357"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1520\/JFS12866J"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01534.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-0968.2002.00363.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl127"}],"container-title":["Therapeutic Apheresis and Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1744-9987.12191","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1744-9987.12191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T13:10:54Z","timestamp":1696165854000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1744-9987.12191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,4]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1111\/1744-9987.12191"],"URL":"https:\/\/doi.org\/10.1111\/1744-9987.12191","archive":["Portico"],"relation":{},"ISSN":["1744-9979","1744-9987"],"issn-type":[{"value":"1744-9979","type":"print"},{"value":"1744-9987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,4]]}}}