Pathology of thrombotic thrombocytopenic purpura in the placenta

PubMed, the Internet portal of biomedical and life sciences literature, indexed an interesting article, entitled Pathology of thrombotic thrombocytopenic purpura in the placenta, with emphasis on the snowman sign (Pediatr Dev Pathol. 2007 Nov-Dec;10(6):455-62.). Authors are Jamshed S Kouides P Sham R et al, from the Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA. Thrombotic thrombocytopenic purpura (TTP) commonly affects women of childbearing age. Although cases of TTP in pregnancy have been reported, the pathology of TTP in the placenta has not been described. In other organs, TTP has a distinctive pathology of arteriolar aneurysms with segmental intramural hyaline deposits. We report 2 cases of TTP in pregnancy, both leading to fetal loss in the 2nd trimester. We noticed a distinctive pathology of TTP in the spiral arteries on the maternal surface of the placenta, particularly the “snowman sign,”In one of our cases, where the clinical diagnosis of TTP was difficult, the distinctive placental findings helped reinforce the clinical decision to perform potentially life-saving plasmapheresis. To access the full abstract of the article, click here